Get the free Confidential Communicable Disease Report—Part 2 - epi publichealth nc
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A confidential report form for healthcare providers to document and report cases of group A streptococcal infections, collecting details on patient symptoms, testing, treatment, and exposure.
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How to fill out Confidential Communicable Disease Report—Part 2
01
Start by entering the patient's personal information at the top, including name, date of birth, and contact details.
02
Fill in the patient's gender and any relevant demographic information.
03
Indicate the type of communicable disease being reported.
04
Provide the date of diagnosis and any significant symptoms experienced by the patient.
05
Document the tests conducted, including the type and results.
06
Note any treatment administered and any relevant medical history.
07
Include the healthcare provider's information and signature.
08
Review the report for accuracy before submitting.
Who needs Confidential Communicable Disease Report—Part 2?
01
Healthcare providers diagnosing communicable diseases.
02
Public health officials for monitoring and control.
03
Laboratories conducting tests for communicable diseases.
04
Emergency responders and outbreak investigators.
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People Also Ask about
What are communicable diseases 2?
In New York City, call 1 (866) NYC-DOH1 (1-866-692-3641) for additional information. Health care personnel in New York City should use the downloadable Universal Reporting Form (PD-16) ; those belonging to NYC MED can complete and submit the form online .
What are two communicable diseases?
A communicable disease is one that spreads from one person or animal to another or from a surface to a person. They are the result of pathogens, such as viruses and bacteria. Communicable diseases include colds and flu.
What are communicable diseases class 2?
Information for Specific Communicable Diseases Chickenpox / Shingles. COVID-19. Ebola. Ending the HIV Epidemic (EHE) Hepatitis B. Hepatitis C. HIV / AIDS. HIV / STDs / Hepatitis.
How do I report a communicable disease in NYC?
How to report a suspected notifiable disease. If the case is an urgent notifiable disease, you must report it by telephone to your local UKHSA health protection team within 24 hours. This is to discuss actions to protect public health. Report all cases on the Report a notifiable disease online service within 3 days.
What are reportable communicable diseases?
Some examples of reportable communicable diseases include HIV, hepatitis A, B, and C, measles, salmonella, measles, and blood-borne illnesses. The most common forms of spread include fecal-oral, food, sexual intercourse, insect bites, contact with contaminated fomites, droplets, or skin contact.
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What is Confidential Communicable Disease Report—Part 2?
Confidential Communicable Disease Report—Part 2 is a specialized form used by healthcare providers to report cases of certain communicable diseases while maintaining patient confidentiality.
Who is required to file Confidential Communicable Disease Report—Part 2?
Healthcare providers who diagnose or treat individuals with specific communicable diseases are required to file Confidential Communicable Disease Report—Part 2.
How to fill out Confidential Communicable Disease Report—Part 2?
To fill out Confidential Communicable Disease Report—Part 2, providers need to follow the instructions provided with the form, ensuring all required fields are completed accurately, including patient demographics and disease information.
What is the purpose of Confidential Communicable Disease Report—Part 2?
The purpose of Confidential Communicable Disease Report—Part 2 is to assist public health authorities in monitoring and controlling the spread of communicable diseases and ensuring effective responses to outbreaks.
What information must be reported on Confidential Communicable Disease Report—Part 2?
Information that must be reported includes the patient’s name, address, date of birth, the type of disease, diagnosis date, and any relevant clinical information that can assist in disease tracking and management.
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