Get the free PERTUSSIS CASE REPORT FORM - wiki phdsc

PERTUSSIS CASE REPORT From This form is intended for field investigations or during times PHI DDO access is unavailable. The order of the form mirrors the case investigation screens in PHI DDO. Enter

How to fill out pertussis case report form

How to fill out pertussis case report form

1. Step 1: Obtain a copy of the pertussis case report form.
2. Step 2: Fill in the patient's personal information such as name, age, and contact details.
3. Step 3: Provide details about the patient's symptoms and the onset of pertussis.
4. Step 4: Include information about any laboratory tests conducted to confirm the diagnosis.
5. Step 5: Describe the treatment administered to the patient and its effectiveness.
6. Step 6: Provide information about any complications or hospitalizations related to pertussis.
7. Step 7: Sign and date the form to validate the information provided.
8. Step 8: Submit the completed pertussis case report form to the relevant health department or agency.

Who needs pertussis case report form?

1. Healthcare professionals who diagnose and treat pertussis cases need the pertussis case report form.
2. Public health departments and agencies use the form to collect data on pertussis cases for surveillance and control purposes.
3. Medical researchers studying pertussis may also require the form to gather epidemiological information.
4. In some regions, healthcare facilities and laboratories are legally mandated to report pertussis cases, and the form is utilized for compliance.

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What is pertussis case report form?

Pertussis case report form is a document used to record and report cases of pertussis, also known as whooping cough, to public health authorities.

Who is required to file pertussis case report form?

Healthcare providers and laboratories are required to file pertussis case report form when they diagnose or detect a case of pertussis.

How to fill out pertussis case report form?

The pertussis case report form should be filled out with accurate information about the patient, including demographics, symptoms, laboratory findings, and treatment received.

What is the purpose of pertussis case report form?

The purpose of the pertussis case report form is to track and monitor cases of pertussis in order to prevent outbreaks and control the spread of the disease.

What information must be reported on pertussis case report form?

Information such as patient demographics, symptoms, laboratory results, treatment history, vaccination status, and contact information must be reported on the pertussis case report form.