SimpleReport is currently experiencing an outage. We're working on getting this fixed as soon as possible.

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Join the SimpleReport waiting list

Thanks for your interest in SimpleReport. We’re working to make this tool available throughout the country. Fill out this form and we’ll let you know when SimpleReport becomes available in your area.

Required fields are marked with an asterisk (*).

Name * Email address * Phone number * State *

Organization * Your facility or the Public Health Department you are representing Check the boxes below for the conditions you're interested in reporting:

COVID-19

Flu A

Flu B

RSV

HIV

If there are any additional conditions you would like to be able to report using SimpleReport, please enter them below. How did you hear about us?

By submitting this form, you agree to our Terms of Service.

Error

Failed to submit. Please try again.

honeypot label