33. A health professional with the authority to make a diagnosis or to assess a person’s state of health who makes a report under this Chapter must send the following information to the competent public health director:
(1) the name of the intoxication, infection or disease being reported;
(2) the surname and given names, sex, profession, date of birth, address, telephone number and health insurance number of the person concerned by the report;
(3) the date of the onset of the disease or symptoms;
(4) where samples have been taken for laboratory analysis, the date on which the samples were taken and the name of the laboratories that will analyze them;
(5) the professional’s surname and given names, professional permit number and telephone numbers where the professional can be reached;
(6) in the case of a report of a disease or infection likely to be transmitted by blood or by organ or tissue donation, the information on the blood, organ or tissue donations of the person affected and the information on the blood, blood products, organs or tissue received by the person affected;
(7) in the case of a report of syphilis, an indication that it is primary, secondary, latent of less than or more than 1 year, congenital, tertiary, or any other form.