Version 1.3

Mortality and causes of death among HIV patients in the UK

This online tool should be used to report information on all deaths among patients attending for HIV care at your clinic and among people with HIV dying at your site. Any questions left incomplete at the time of submission will be defaulted to "unknown".
This form can save partial responses, to be completed at a later date. Click "Save" and bookmark the unique link that is generated. Return to this link to resume inputting information.

If you have any queries, please contact Ammi Shah (UKHSA) at or 020 8327 7095.

Contact information

To report a death among a patient with HIV, you must supply your contact information. You may be contacted to verify your identity, clarify your responses or follow-up missing information.
Questions in red and marked with an asterisk (*) are mandatory.
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