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Human Influenza A (H₅) Domestic Case Screening Form 1. Reported By Date reported to IDEA: / / mmddyyyAssigned Case ID: y2. Patient Information Patient Last Name:First Name:Address:Phone:City of
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Start by obtaining the v2020116 avian influenza initial form.
02
Carefully read and understand the instructions provided with the form.
03
Fill in your personal information, such as name, address, contact details, etc., in the designated fields.
04
Provide the necessary information regarding the poultry farm or facility, including its location, size, and type of operation.
05
Answer all the questions related to biosecurity measures implemented on the farm, vaccination history, and any previous avian influenza incidents.
06
Ensure that you accurately describe any clinical signs or symptoms observed in the poultry, if applicable.
07
Attach any supporting documents or records that are requested, such as laboratory test results or vaccination certificates.
08
Review the completed form to ensure all the information is accurate and complete.
09
Sign and date the form.
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Submit the filled-out v2020116 avian influenza initial form to the relevant authorities as specified in the instructions.

Who needs v2020116 avian influenza initial?

01
The v2020116 avian influenza initial form is required by poultry farmers or facility operators who have encountered situations related to avian influenza or need to report any potential outbreaks.
02
It is also necessary for individuals or organizations responsible for poultry health and surveillance to gather comprehensive data on avian influenza cases.
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The v2020116 avian influenza initial is a form that reports the initial findings and data regarding occurrences of avian influenza, aimed at tracking outbreaks and implementing biosecurity measures.
Individuals or organizations involved in the poultry industry, including farmers, poultry processors, and veterinarians who detect or suspect cases of avian influenza are required to file the v2020116 avian influenza initial.
To fill out the v2020116 avian influenza initial, one must provide detailed information on the location of the outbreak, the type of birds affected, the nature of the symptoms observed, and any biosecurity measures taken.
The purpose of the v2020116 avian influenza initial is to ensure timely reporting of avian influenza cases to help monitor and control outbreaks, thereby protecting poultry health and preventing the spread to humans.
The v2020116 avian influenza initial requires reporting information such as the date of detection, species and number of affected birds, clinical signs, location, and any relevant biosecurity practices implemented.
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