CO Campylobacteriosis Case Investigation Form 2015-2025 free printable template

Colorado Department of Public Health and Environment Communicable Disease Epidemiology Program 4300 Cherry Creek Dr S, Denver, CO 80246 Phone 3036922700, Fax 3037820338 CAMPYLOBACTERIOSIS CASE INVESTIGATION

How to fill out CO Campylobacteriosis Case Investigation Form

How to fill out CO Campylobacteriosis Case Investigation Form

1. Begin by entering the patient's personal information including name, address, and contact details.
2. Fill out the demographic information such as age, sex, and ethnicity.
3. Record the date of symptom onset and any hospital admission details.
4. Document the patient's clinical history, including any prior medical conditions and medications.
5. Collect information regarding the exposure history, including food and water sources.
6. Note any travel history that may be relevant to the case.
7. Include laboratory test results and dates relevant to the diagnosis.
8. Provide information about any contacts or outbreaks associated with the case.
9. Review the form for completeness and accuracy before submission.

Who needs CO Campylobacteriosis Case Investigation Form?

1. Healthcare providers diagnosing or reporting cases of Campylobacteriosis.
2. Public health officials investigating outbreaks and monitoring disease trends.
3. Laboratories performing testing for Campylobacteriosis.
4. Epidemiologists collecting data for surveillance and research purposes.

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What is CO Campylobacteriosis Case Investigation Form?

The CO Campylobacteriosis Case Investigation Form is a document used by public health officials to gather data on cases of Campylobacteriosis, a bacterial infection that affects the gastrointestinal system.

Who is required to file CO Campylobacteriosis Case Investigation Form?

Healthcare providers and laboratories are required to file the CO Campylobacteriosis Case Investigation Form when they confirm a case of Campylobacteriosis.

How to fill out CO Campylobacteriosis Case Investigation Form?

To fill out the CO Campylobacteriosis Case Investigation Form, you need to provide patient demographics, clinical information, exposure history, and laboratory findings as prompted by the form.

What is the purpose of CO Campylobacteriosis Case Investigation Form?

The purpose of the CO Campylobacteriosis Case Investigation Form is to monitor and control the spread of Campylobacteriosis, to gather epidemiological data, and to facilitate public health interventions.

What information must be reported on CO Campylobacteriosis Case Investigation Form?

The information that must be reported includes personal demographics, onset date of symptoms, clinical features, diagnostic tests performed, potential sources of infection, and any relevant travel history.