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NY WCDH CDC Novel Pandemic Person Under Investigation (PUI) and Case Report Form 2020-2025 free printable template

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ATTENTION George Latimer County ExecutivePublic Health AlertSherlita Adler, M.D. Commissioner of Healthcare:March 5, 2020SUBJECT:2019 NOVEL CORONAVIRUS (COVID-19) CDC Updated Guidance, Patient Questionnaire
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How to fill out NY WCDH CDC Novel Pandemic Person Under Investigation

01
Begin by downloading the NY WCDH CDC Novel Pandemic Person Under Investigation form from the official website.
02
Fill in the patient's personal information, including name, date of birth, and contact details.
03
Provide information regarding the patient’s symptoms, such as fever, cough, or respiratory issues.
04
Indicate the date when symptoms first appeared.
05
Fill out the section regarding potential exposure to COVID-19, including travel history and contact with confirmed cases.
06
Complete the section for healthcare provider information, including name and contact details.
07
Carefully review the entire form for accuracy and completeness.
08
Submit the filled form to the appropriate local health department, either by mail or electronically.

Who needs NY WCDH CDC Novel Pandemic Person Under Investigation?

01
Individuals who have symptoms of COVID-19 and may have been exposed to the virus.
02
Healthcare providers who are managing patients suspected of having COVID-19.
03
Local health authorities needing information for contact tracing and public health response.
04
Employers needing documentation for employees who show symptoms or have been exposed to the virus.
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The NY WCDH CDC Novel Pandemic Person Under Investigation is a designation used for individuals who may have been exposed to a novel virus and are being monitored for symptoms and potential infection.
Healthcare providers, public health officials, and laboratories are required to file the NY WCDH CDC Novel Pandemic Person Under Investigation when they identify a patient meeting the criteria for potential exposure to a novel virus.
To fill out the NY WCDH CDC Novel Pandemic Person Under Investigation, complete the designated form by providing accurate patient information, details of the potential exposure, and any relevant clinical signs or symptoms.
The purpose of the NY WCDH CDC Novel Pandemic Person Under Investigation is to facilitate tracking, monitoring, and management of individuals who may pose a risk of spreading a novel infectious disease, ensuring prompt public health responses.
The information that must be reported includes patient demographics, exposure history, clinical symptoms, test results, and any relevant travel history or contact with confirmed cases.
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