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Patients Name:Initial Report Date & Source:Nurse Case Manager:Case Management Team:Directions: Blank boxes indicate week(s) TB service is to be provided. Document date and initials of the provider
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The report date is the date when the initial report on the patient's condition was filed.
Healthcare providers and facilities are required to file the initial report on the patient's condition.
The report can be filled out online through the designated reporting system or submitted via mail.
The purpose of the initial report is to document the patient's condition at a specific point in time for reference and tracking purposes.
The report must include the patient's name, date of birth, medical history, current diagnosis, and any treatment or medications prescribed.
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