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Pertussis Case Worksheet Patient Name: Male Female DOB: Race: Ethnicity: Address: Phone: City: State: AK Other: Health Care Provider: Phone: Contact to a lab confirmed case? Yes No Unknown If YES,
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How to fill out investigation worksheet - DHSS:

01
Begin by gathering all relevant information regarding the investigation, such as dates, times, locations, and individuals involved.
02
Start by filling out the top section of the worksheet, which typically includes general information like the case number, investigator's name, and the date the form is being completed.
03
Move on to the section where you will provide a brief summary of the investigation or incident. This summary should include a concise description of what occurred and any important details that may be relevant to the investigation.
04
Next, proceed to the section where you will document the individuals involved in the investigation. This includes information such as their names, contact details, and their role or relationship to the investigation.
05
Following that, go through the worksheet and complete any sections related to specific aspects of the investigation, such as interviews conducted, evidence collected, or any actions taken during the investigation.
06
Make sure to be thorough and accurate when filling out each section of the worksheet, providing detailed information and supporting documentation if available.
07
Finally, review the completed worksheet for any errors or missing information, making any necessary amendments before submitting it as required.

Who needs investigation worksheet - DHSS?

The investigation worksheet - DHSS is typically needed by individuals or organizations conducting investigations within the Department of Health and Human Services (DHSS). This may include DHSS employees, investigators, compliance officers, or other relevant parties involved in the investigation process. The worksheet serves as a standardized form to record and document important information related to the investigation, ensuring consistency and clarity throughout the process.
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Investigation worksheet - DHSS is a document used by the Department of Health and Human Services to gather information related to investigations.
Any organization or individual involved in an investigation conducted by DHSS may be required to file the investigation worksheet.
The investigation worksheet can be filled out by providing accurate and detailed information about the investigation, including dates, parties involved, and findings.
The purpose of the investigation worksheet is to document and track information related to investigations, ensuring transparency and accountability.
Information such as incident details, investigation timeline, involved parties, and conclusions must be reported on the investigation worksheet.
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