AZ Reportable Event Record/Report 2012 free printable template
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Arizona Department of Health Services Division of Licensing Services Long Term Care Licensing 150 N. 18th Ave., Ste. 440 Phoenix, AZ 85007 Phone: (602) 364-2690 After Hours: (602) 364-2677 Fax: (602)
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How to fill out AZ Reportable Event RecordReport
How to fill out AZ Reportable Event Record/Report
01
Gather necessary information about the event, including date, time, and location.
02
Identify the individuals involved in the event and their roles.
03
Describe the nature of the event clearly and concisely.
04
Document any immediate actions taken in response to the event.
05
Collect witness statements if applicable.
06
Confirm that all required fields are completed in the report template.
07
Review the report for accuracy and completeness.
08
Submit the report to the appropriate authorities for review.
Who needs AZ Reportable Event Record/Report?
01
Organizations that operate within Arizona and are subject to reporting requirements.
02
Employees or volunteers who are involved in reportable events.
03
Supervisors and management responsible for ensuring compliance with reporting protocols.
04
Regulatory bodies that require tracking of reportable events.
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People Also Ask about
What sexually transmitted diseases have to be reported?
Licensed medical providers are required to report every case of PID , gonorrhea, chlamydia, syphilis (all stages), LGV , chancroid and granuloma inguinale within 4 days of diagnosis. Complete and return a Sexually Transmitted Disease Case Report Form to the Sexually Transmitted Diseases Program.
How do I report a communicable disease in Arizona?
To report a communicable disease or outbreak, please call 602-506-6767.
Why is chlamydia a reportable disease?
Reportable Sexually Transmitted Infections The local health department is required by state law to make efforts to contact individuals who have been diagnosed with sexually transmitted infections to help prevent the further passage of the infection through intervention, consultation and disease surveillance.
Is chlamydia a reportable disease in Arizona?
Every state has its own list of reportable diseases. For example, in Arizona, a health care provider must report new cases of chlamydia and gonorrhea within five days, and must report new cases of chancroid, HIV, and syphilis within 30 days.
Does chlamydia need to be reported?
Laboratory confirmed cases of Chlamydia trachomatis infections must be reported to MDH within one working day.
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What is AZ Reportable Event Record/Report?
AZ Reportable Event Record/Report is a document that organizations must use to report specific events that have implications for compliance or regulatory oversight in Arizona.
Who is required to file AZ Reportable Event Record/Report?
Organizations, businesses, or individuals that are subject to regulations that require reporting of certain events or changes in Arizona are required to file the AZ Reportable Event Record/Report.
How to fill out AZ Reportable Event Record/Report?
To fill out the AZ Reportable Event Record/Report, one must complete all required fields accurately, provide necessary documentation, and ensure that the submission complies with local regulations.
What is the purpose of AZ Reportable Event Record/Report?
The purpose of the AZ Reportable Event Record/Report is to provide transparency and accountability in reporting significant events that may affect public safety, health, or welfare in Arizona.
What information must be reported on AZ Reportable Event Record/Report?
The information that must be reported on the AZ Reportable Event Record/Report typically includes the date of the event, a description of the event, location, involved parties, and any actions taken in response.
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