Get the free Lyme disease surveillance form - BC Centre for Disease Control - bccdc
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Epidemiology Services BC Center for Disease Control Society 655 W 12th Ave Vancouver BC V5Z 4R4 Tel:(604) 707-2517 Fax: (604)707-2516 www.bccdc.ca LYME DISEASE SURVEILLANCE FORM HEALTH AUTHORITY INFORMATION
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How to fill out lyme disease surveillance form
How to fill out a Lyme disease surveillance form:
01
The first step is to gather the necessary information. The form typically requires personal details such as name, age, contact information, and address.
02
Next, provide a detailed account of any symptoms you may have experienced. This can include fever, fatigue, joint pain, and muscle aches. Be sure to note the date of symptom onset and the duration of each symptom.
03
You will also be asked to provide information about any recent tick bites or exposure to tick-infested areas. Include details such as the date, location, and duration of the exposure.
04
If you have received a diagnosis for Lyme disease, indicate the date and the name of the healthcare provider who made the diagnosis. Provide any relevant laboratory test results, if available.
05
Finally, review the form for completeness and accuracy before submitting it. Make sure all sections are filled out and double-check your contact information.
Who needs a Lyme disease surveillance form?
01
Healthcare professionals: Physicians, nurses, and other healthcare providers use Lyme disease surveillance forms to track and monitor the occurrence of the disease within a specific region or population. These forms help in identifying trends, assessing the spread of the disease, and implementing preventive measures.
02
Public health agencies: Government agencies responsible for disease surveillance and control use these forms to collect data and analyze the epidemiology of Lyme disease. This information is crucial in developing strategies to prevent and control the spread of the disease.
03
Research institutions: Researchers studying Lyme disease may require data from surveillance forms to conduct studies, analyze the effectiveness of treatments, or evaluate the impact of preventive measures. These forms provide valuable data for research purposes.
In conclusion, filling out a Lyme disease surveillance form involves providing personal details, symptom information, tick exposure history, and diagnosis details. Healthcare professionals, public health agencies, and research institutions are among those who use these forms to monitor and study the disease.
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