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Illinois Department of Public Health Division of Laboratories Communicable Diseases Laboratory Test Requisition Laboratory Specimen Number (FOR PUBLIC HEALTH USE ONLY) Please type or use indelible
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What is fformscommdisfrmcdform082002wpd - idph state?
This form is a communicable disease case report form used by the Illinois Department of Public Health (IDPH) to collect information about individuals with specific communicable diseases.
Who is required to file fformscommdisfrmcdform082002wpd - idph state?
Healthcare providers, laboratories, and other entities are required to file this form with IDPH when they suspect or diagnose a patient with a reportable communicable disease.
How to fill out fformscommdisfrmcdform082002wpd - idph state?
The form must be completed with accurate information about the individual affected, the disease diagnosed, and other relevant details. It can be submitted online or via mail.
What is the purpose of fformscommdisfrmcdform082002wpd - idph state?
The purpose of this form is to help IDPH track and monitor communicable diseases in Illinois, as well as to implement public health interventions to prevent the spread of these diseases.
What information must be reported on fformscommdisfrmcdform082002wpd - idph state?
Information required on the form includes the patient's demographic data, details about the disease, onset of symptoms, laboratory testing results, and any known contacts that may have been exposed.
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