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THE U.S. ZIKA PREGNANCY REGISTRY CALIFORNIA DATA SUBMISSION PROCESSInfant Followup Form The California Department of Public Health (CDP) is participating in the U.S. Zika Pregnancy Registry and is the

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How to fill out form us zika pregnancy

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To fill out the US Zika Pregnancy form, follow these steps:

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Open the US Zika Pregnancy form on your preferred web browser.

03

Begin by providing your personal information, including your full name, date of birth, and contact details.

04

Specify your current location and travel history, particularly if you have recently traveled to regions affected by Zika virus.

05

Answer the questionnaire regarding your possible exposure to Zika virus, such as mosquito bites, sexual contact, or blood transfusions.

06

Provide information about your pregnancy, including the estimated due date and the name of your healthcare provider.

07

Indicate any symptoms or complications related to your pregnancy, such as fever, rash, or preterm labor.

08

If applicable, report any laboratory testing or ultrasound results you have received.

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Double-check all the information you have provided to ensure accuracy.

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Submit the completed form by clicking the 'Submit' button at the end of the page.

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Keep a copy of the confirmation page or any reference number provided for future communication or tracking purposes.

Who needs form us zika pregnancy?

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The US Zika Pregnancy form is primarily needed by pregnant women who may have been exposed to Zika virus or are experiencing symptoms related to Zika infection.

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Additionally, healthcare providers may also require this form to monitor and assess the potential risks and complications associated with Zika virus during pregnancy.

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What is form us zika pregnancy?

Form US Zika Pregnancy is a form used to report cases of pregnant individuals with Zika virus infection.

Who is required to file form us zika pregnancy?

Healthcare providers and laboratories are required to file Form US Zika Pregnancy.

How to fill out form us zika pregnancy?

Form US Zika Pregnancy should be filled out with information about the pregnant individual's demographics, Zika virus testing results, pregnancy status, and travel history.

What is the purpose of form us zika pregnancy?

The purpose of Form US Zika Pregnancy is to monitor and track cases of pregnant individuals with Zika virus infection to inform public health response.

What information must be reported on form us zika pregnancy?

Information such as demographics, Zika virus testing results, pregnancy status, and travel history must be reported on Form US Zika Pregnancy.

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