Get the free CDPH Zika Case Report form - California Department of ...
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Zika Virus Report Form (Report by completing and faxing this form to 8605097910. For questions, call 8605097994.) Patient Name (Last)(First)Address (No. And Street)(MI) (Apt. #)(City or Town)Gender
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How to fill out cdph zika case report
How to fill out cdph zika case report
01
To fill out the CDPH Zika Case Report, follow these steps:
02
Start by providing the patient's personal information, including their name, date of birth, gender, and contact information.
03
Specify the patient's travel history, including the countries visited and the dates of travel.
04
Indicate the symptoms experienced by the patient, such as fever, rash, joint pain, or conjunctivitis.
05
Mention the date of the onset of symptoms.
06
Provide information about any laboratory testing conducted on the patient, including the type of test, date of testing, and results.
07
Include any relevant medical history of the patient, such as pregnancy status or underlying health conditions.
08
If applicable, mention if the patient is pregnant or attempting to conceive.
09
Record any additional information or notes that may be relevant to the case.
10
Review the filled-out report for accuracy and completeness before submitting it.
11
Submit the completed CDPH Zika Case Report to the appropriate authority or department as per the reporting guidelines.
Who needs cdph zika case report?
01
The CDPH Zika Case Report is required by healthcare professionals, laboratories, and public health authorities who are responsible for tracking and monitoring Zika virus cases.
02
It is typically needed in situations where a person is suspected or confirmed to have been infected with the Zika virus.
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What is cdph zika case report?
The cdph zika case report is a document used to report cases of Zika virus infection to the California Department of Public Health (CDPH).
Who is required to file cdph zika case report?
Healthcare providers and laboratories are required to file cdph zika case report.
How to fill out cdph zika case report?
The cdph zika case report should be filled out with relevant patient information, including demographics, symptoms, travel history, and laboratory test results.
What is the purpose of cdph zika case report?
The purpose of cdph zika case report is to track and monitor Zika virus infections in California.
What information must be reported on cdph zika case report?
Information such as patient demographics, symptoms, travel history, and laboratory test results must be reported on cdph zika case report.
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