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Contact Investigation Notes
Name of
Contact
(First and
Last)If Minor,
Name of
GuardianDate
ExposedPlace of
ExposureExposure
Details /
Interphone
NumberEmail
AddressSymptoms
of COVID-19? (Y, N, U)Contraction
Needed
(Quarantine,
Self
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How to fill out contact investigation notes form
How to fill out contact investigation notes form
01
To fill out the contact investigation notes form, follow these steps:
02
Start by entering the basic details of the person being investigated, such as their name, age, contact information, and occupation.
03
In the next section, provide information about the potential sources of exposure, including any known contacts or places visited by the person.
04
Document the dates of contact or exposure, along with any relevant details about the nature of the interaction or location.
05
Use the provided space to write down any symptoms experienced by the person being investigated, including the date of onset and severity.
06
Include information about any medical tests or treatments they have undergone, along with the results if available.
07
Provide space for additional comments or notes that may be relevant to the investigation.
08
Finally, ensure that all the information provided is accurate and legible before submitting the form for further processing.
Who needs contact investigation notes form?
01
The contact investigation notes form is needed by healthcare professionals, such as doctors, nurses, and public health officials, who are responsible for conducting contact tracing and investigating potential COVID-19 cases.
02
It is also used by healthcare institutions, clinics, and hospitals to maintain accurate records and aid in the monitoring and control of contagious diseases.
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What is contact investigation notes form?
The contact investigation notes form is a document used to record and track contact information and interactions during the investigation of potential public health concerns, such as infectious disease outbreaks.
Who is required to file contact investigation notes form?
Individuals conducting public health investigations, such as epidemiologists, public health officials, and healthcare providers, are typically required to file the contact investigation notes form.
How to fill out contact investigation notes form?
To fill out the contact investigation notes form, one must provide detailed information about the contacts made, including names, contact details, dates, and any relevant notes about the interactions or health status.
What is the purpose of contact investigation notes form?
The purpose of the contact investigation notes form is to systematically gather and document information on contacts related to a public health investigation for better management and follow-up.
What information must be reported on contact investigation notes form?
The information that must be reported includes the names and contact details of individuals involved, dates of interactions, relevant health information, and any actions taken during the investigation.
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