Get the free Human Exposure Rabies Questionnaire - PA Department of Health

Human Exposure Rabies Questionnaire HR 102.71 (16 Jan 18)(http://www.dsf.health.state.pa.us/health/lib/health/labs/rabies_form_2006.pdf)Bureau of Laboratories Submits Completed Form together with

How to fill out human exposure rabies questionnaire

How to fill out human exposure rabies questionnaire

1. To fill out the human exposure rabies questionnaire, follow these steps:
2. Start by providing your personal information, including your name, contact details, age, and address.
3. Specify the date and time of the animal exposure incident.
4. Provide details about the animal involved, such as its species, breed (if known), and any unique identifying marks.
5. Describe the type of exposure, whether it was a bite, scratch, or other contact with the animal's saliva or nervous tissue.
6. Indicate the body part(s) affected by the exposure and any immediate first aid measures taken.
7. Answer questions regarding your vaccination history, including previous rabies vaccinations and the date of the last dose.
8. Disclose any symptoms or medical conditions you are currently experiencing.
9. Provide information about the animal's behavior before and during the exposure incident.
10. State whether the animal is currently alive, dead, or unknown.
11. Finally, sign and date the questionnaire to confirm the accuracy of your responses.

Who needs human exposure rabies questionnaire?

1. The human exposure rabies questionnaire is needed by individuals who have been exposed to an animal suspected of having rabies.
2. This includes individuals who have been bitten, scratched, or had contact with the saliva or nervous tissue of an animal, especially if the animal showed abnormal or aggressive behavior.
3. Healthcare professionals, animal control officers, and public health agencies may also require the questionnaire to assess the risk of rabies transmission and determine the appropriate course of action.

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What is human exposure rabies questionnaire?

The human exposure rabies questionnaire is a form used to assess the potential risk of rabies exposure in individuals who have been bitten or scratched by an animal suspected of carrying rabies.

Who is required to file human exposure rabies questionnaire?

Individuals who have been exposed to potentially rabid animals, healthcare providers, and public health officials are typically required to file the human exposure rabies questionnaire.

How to fill out human exposure rabies questionnaire?

To fill out the human exposure rabies questionnaire, individuals should provide personal details, details of the exposure incident, the type of animal involved, and any previous rabies vaccinations.

What is the purpose of human exposure rabies questionnaire?

The purpose of the human exposure rabies questionnaire is to evaluate the need for rabies post-exposure prophylaxis and to monitor rabies exposure cases for public health safety.

What information must be reported on human exposure rabies questionnaire?

Information that must be reported includes the date of exposure, the species of animal involved, vaccination status of the exposed individual, and medical history related to the exposure.