Get the free Kentucky Reportable Disease Form - Constant Contact

EPIC 394 Revised Sept 2016 Kentucky Reportable Disease Form Department for Public Health, Division of Epidemiology and Health Planning 275 East Main St., Mail stop HS2EA Frankfort, KY 406210001 Hepatitis

How to fill out kentucky reportable disease form

How to fill out kentucky reportable disease form

1. Review the Kentucky reportable disease form to familiarize yourself with the information required.
2. Gather all the necessary information such as patient details, disease name, symptoms, and relevant medical history.
3. Ensure you have access to the most recent version of the form, which can be obtained from the Kentucky Department of Public Health website.
4. Begin by filling out the patient's personal information section, including their name, address, date of birth, and contact details.
5. Provide details about the disease being reported, including the name, suspected or confirmed diagnosis, and any relevant laboratory results.
6. If applicable, provide information about the healthcare facility where the patient is being treated or was diagnosed.
7. Include information about any subsequent treatment or interventions that have taken place.
8. Ensure all sections of the form are completed accurately and legibly.
9. Review the completed form for any errors or missing information before submitting it.
10. Submit the filled-out reportable disease form to the designated authority or healthcare department as instructed.
11. Retain a copy of the completed form for your records.

Who needs kentucky reportable disease form?

1. Healthcare professionals such as doctors, nurses, and other medical practitioners who diagnose or treat reportable diseases in Kentucky.
2. Public health officials and departments responsible for monitoring and controlling the spread of infectious diseases.
3. Laboratories conducting tests and analyses to confirm diagnoses of reportable diseases.
4. Medical facilities and institutions where patients with reportable diseases receive treatment or care.
5. Any individual or entity responsible for reporting suspected or confirmed cases of specific diseases as mandated by Kentucky state law.

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