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Influenza Quick Symptom Screen (draft)Name of Outbreak / Cluster Date / / Name: Address: City: ZIP: Phone: What is your date of birth? / / I. Do you have any medical problems, such as: Chronic heart
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Step 3: Provide accurate answers to each question based on your symptoms
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Who needs influenza quick symptom screen?

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Anyone who suspects they may be experiencing symptoms of influenza
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Individuals who want to assess their risk of having influenza
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Healthcare professionals who need to evaluate patients for possible influenza cases
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The influenza quick symptom screen is a tool used to rapidly identify symptoms associated with influenza in individuals, helping to facilitate timely diagnosis and treatment.
Healthcare providers and institutions that diagnose or treat patients with influenza are typically required to file the influenza quick symptom screen.
To fill out the influenza quick symptom screen, healthcare providers must collect patient symptom information, document it accurately on the form, and submit it to the relevant health authority as per guidelines.
The purpose of the influenza quick symptom screen is to ensure early detection of influenza cases, promote appropriate public health response, and monitor the spread of the virus.
The information that must be reported includes patient demographics, symptom onset date, specific symptoms experienced, and any relevant clinical test results.
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