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Malaria PATIENT DEMOGRAPHICS Name (last, first): Address (mailing): Address (physical): City/State/Zip: Phone (home): Phone (work/cell) : Alternate contact: Parent/Guardian Spouse Other Name: Phone:
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How to fill out malaria - wv dhhr
How to fill out malaria - wv dhhr:
01
Obtain the necessary form from the West Virginia Department of Health and Human Resources (WV DHHR) website or local health office.
02
Begin by providing your personal information, such as your full name, date of birth, and contact details.
03
Fill in the specific details related to malaria, including the date of onset, symptoms experienced, and any travel history to malaria-endemic areas.
04
Provide information about any tests conducted for malaria, including the type of test, date, and results.
05
If applicable, include details about any treatments received for malaria, such as medication, dosage, and duration.
06
If you are a healthcare professional reporting a case, ensure to include your name, credentials, and contact information for follow-up purposes.
07
Review the completed form for accuracy and completeness before submitting it to the WV DHHR.
Who needs malaria - wv dhhr:
01
Individuals who have been diagnosed with malaria and are seeking to report their case to the West Virginia Department of Health and Human Resources.
02
Healthcare professionals who have identified a patient with malaria and are required to report it to the WV DHHR for surveillance and monitoring purposes.
03
Individuals who have been in close contact with a confirmed or suspected case of malaria, as they may need to provide relevant information for contact tracing or preventive measures.
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What is malaria - wv dhhr?
Malaria - West Virginia Department of Health and Human Resources is a reportable infectious disease.
Who is required to file malaria - wv dhhr?
Healthcare providers, laboratories, and other specified entities are required to file malaria - wv dhhr.
How to fill out malaria - wv dhhr?
To fill out malaria - wv dhhr, the reporting entity must provide information on the diagnosed case of malaria, including details on the patient and the disease.
What is the purpose of malaria - wv dhhr?
The purpose of malaria - wv dhhr is to track and monitor cases of malaria in the state of West Virginia.
What information must be reported on malaria - wv dhhr?
Information such as patient demographics, date of diagnosis, laboratory results, and treatment information must be reported on malaria - wv dhhr.
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