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How Do You Self-report?

You may self-report by doing one of the following:

  • Print the form and fax to a confidential fax number 515-242-0155 or mail to IPHP, 400 SW 8th, Suite C, Des Moines, IA 50309-4686.

  • Contacting Amy Van Maanen, Program Coordinator (515) 281-6006.
    (You may leave a confidential message on voice mail); or
  • Email (amy.vanmaanen@iowa.gov)