TN Person Under Investigation (PUI) and Case Report Form 2020-2025 free printable template
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Attachment 3. PUB Form CDC 2019nCoV ID:Form Approved: OMB: 09201011 Exp. 4/23/2020PATIENT IDENTIFIER INFORMATION IS NOT TRANSMITTED TO CDC Patient first name Patient last name Date of birth (MM/DD/YYY):
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How to fill out TN Person Under Investigation (PUI) and Case Report
01
Obtain the TN Person Under Investigation (PUI) and Case Report form from the appropriate health department or agency.
02
Fill in the basic personal information of the individual in question, including name, date of birth, and contact details.
03
Provide information regarding the individual's symptoms, including dates of onset and severity.
04
Document any relevant travel history or exposure to known cases.
05
Include the date when the report is being filled out.
06
Attach any supporting documents or test results that may be relevant to the investigation.
07
Review all information for accuracy and completeness before submitting.
Who needs TN Person Under Investigation (PUI) and Case Report?
01
Health care providers who suspect a patient may be a Person Under Investigation (PUI) for certain diseases.
02
Public health officials who need to monitor and track potential outbreaks.
03
Laboratories that require information for processing tests related to the individual's case.
04
Emergency response teams that may need to assess the risk and take appropriate actions.
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What is TN Person Under Investigation (PUI) and Case Report?
A TN Person Under Investigation (PUI) and Case Report is a document used to identify individuals who are suspected of having a communicable disease, allowing health authorities to track potential outbreaks and implement appropriate public health measures.
Who is required to file TN Person Under Investigation (PUI) and Case Report?
Health care providers, laboratories, and facilities that suspect or confirm a case of a communicable disease are typically required to file a TN Person Under Investigation (PUI) and Case Report.
How to fill out TN Person Under Investigation (PUI) and Case Report?
To fill out the TN Person Under Investigation (PUI) and Case Report, the reporter must provide specific information including patient demographics, clinical details, travel history, exposure risks, and other relevant medical data as outlined in the reporting guidelines.
What is the purpose of TN Person Under Investigation (PUI) and Case Report?
The purpose of the TN Person Under Investigation (PUI) and Case Report is to ensure timely reporting of potential communicable diseases to facilitate public health responses, contact tracing, and outbreak management.
What information must be reported on TN Person Under Investigation (PUI) and Case Report?
The information that must be reported includes the individual's name, date of birth, address, clinical symptoms, travel history, exposure details, test results, and the names of health care providers involved in the case.
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