Rapid Test Reporting Form

   This is a State of New Hampshire reporting system and is provided only for authorized use. State and federal statutes make it a crime to attempt and/or gain unauthorized access. Unauthorized use may be subject to criminal civil and/or administrative action. By clicking “Begin Survey” you are certifying that you are authorized by your organization to submit these data and you agree to report only actual COVID-19 test results that your organization conducted.
   You will be asked to enter one test result at a time. After submitting each test result, you will be provided the option of entering another test result.
   Reporting of all personally identifiable and demographic information for COVID-19 test results is required by federal and state law. Please complete all fields for which you have information.
   If you have any issues or need to correct your submittal, please email NHAntigenReporting@dhhs.nh.gov as the primary means or, contact the Public Health COVID-19 Operations Center at 603-271-6996, Monday through Sunday between 8am and 8pm.

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