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Name of Institution: Address & Phone #: Fax #: Date of Onset: Date Outbreak Declared: OUTBREAK LINE LISTING FORM Case Definition: LCF Respiratory/Enteric Outbreak# Date of Onset WMD U.R.I. Specimen

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What is outbreak line listing form?

The outbreak line listing form is a document used to track and record information about individuals affected by a particular outbreak.

Who is required to file outbreak line listing form?

Health officials, healthcare facilities, and other relevant organizations are required to file outbreak line listing forms.

How to fill out outbreak line listing form?

The outbreak line listing form should be filled out with the necessary information about each individual affected by the outbreak, such as their name, age, symptoms, and contact information.

What is the purpose of outbreak line listing form?

The purpose of the outbreak line listing form is to help track and monitor the spread of an outbreak, as well as identify commonalities among those affected.

What information must be reported on outbreak line listing form?

Information such as the individual's name, age, location, symptoms, and any relevant contact information must be reported on the outbreak line listing form.

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