DHHS 2124 2009 free printable template

NC Electronic Disease Surveillance System NCE DSS EVENT ID# North Carolina Department of Health and Human Services Division of Public Health Epidemiology Section Communicable Disease Branch ATTENTION

How to fill out DHHS 2124

How to fill out DHHS 2124

1. Obtain the DHHS 2124 form from the official website or local DHHS office.
2. Fill in the applicant's personal information, including name, address, and contact details.
3. Provide necessary identification information, such as Social Security number or case number.
4. Complete the income and financial information section, detailing all sources of income.
5. Indicate any additional assistance or services requested, if applicable.
6. Review the form for accuracy and completeness before submitting.
7. Submit the form to the designated DHHS office either by mail or in person.

Who needs DHHS 2124?

1. Individuals or families applying for assistance programs provided by the Department of Health and Human Services.
2. People seeking support related to social services, healthcare, and financial aid.

People Also Ask about

What is the process for reporting notifiable diseases from individuals to the CDC?

Case Reporting A doctor diagnoses and/or a laboratory confirms a reportable disease. The hospital, healthcare provider, or laboratory sends information about this case to the public health department. The NNDSS team receives, secures, processes, and provides de-identified data to disease-specific programs across CDC.

How are communicable diseases reported?

A communicable disease can be reported by phone, fax, or e-mail through the Communicable Disease Reporting System (CDRS).

Is salmonella reportable in NC?

North Carolina law mandates healthcare providers and laboratories to report over 70 diseases or conditions to their local health department. Some examples of the reportable communicable diseases include Hepatitis A, B & C, coronavirus, influenza, measles, and salmonella and other food borne illnesses.

What is the process of reporting a communicable disease?

A communicable disease can be reported by phone, fax, or e-mail through the Communicable Disease Reporting System (CDRS).

What pathogens should be reported?

Infection with Salmonella, Shiga-toxin producing Escherichia coli (STEC, including O157 and other serogroups), Listeria, Shigella, Vibrio, and hepatitis A virus, as well as botulism, are reportable almost everywhere in the United States.

Is chlamydia a reportable disease?

Syphilis (including congenital syphilis), gonorrhea, chlamydia, chancroid, and HIV are reportable diseases in every state.

Which STDs are reportable to public health?

Human immunodeficiency virus (HIV)Find key information and public health guidance for the screening, diagnosis and treatment of: Chlamydia (including lymphogranuloma venereum) Gonorrhea. Genital herpes. Human papillomavirus (HPV) Mycoplasma genitalium. Syphilis.

What is the process for making a disease reportable?

Mandatory written reporting: A report of the disease must be made in writing. Examples are gonorrhea and salmonellosis. Mandatory reporting by telephone: The provider must make a report by phone. Examples are rubeola (measles) and pertussis (whooping cough).

Is trichomoniasis reportable in NC?

Report any confirmed (documented) case on a DHHS Form 2124 for STIs and DHHS Form 4114. Please note that Herpes Simplex Virus (HSV) and Trichomoniasis are not reportable to the local health department. Forward any questions concerning reporting and/or treatment to contact person listed on form.

Which STD is not reportable in all states?

Non-reportable Sexually Transmitted Infections Include: Bacterial Vaginosis (BV) Genital Herpes. Human Papillomavirus (HPV) Pediculosis (Pubic Lice) Trichomoniasis.

Does trichomoniasis need to be reported?

Trichomoniasis is estimated to be the most prevalent nonviral STI worldwide, affecting approximately 2.6 million persons in the United States (838,1055). Because trichomoniasis is not a reportable disease (1056), and no recommendations are available for general screening for T.

What is the purpose of reporting communicable diseases?

Reporting of cases of communicable disease is important in the planning and evaluation of disease prevention and control programs, in the assurance of appropriate medical therapy, and in the detection of common-source outbreaks.

What is the most common STD in North Carolina?

Communicable Disease Table A displays the overall number of reportable STD cases in NC in 2019. The majority of STDs reported were chlamydia, gonorrhea, and syphilis.

What are the 5 reportable diseases?

Annual Summaries of Notifiable Diseases Cholera. Cryptosporidiosis. Cyclosporiasis. Giardiasis. Hepatitis A. Legionellosis. Malaria* Salmonellosis.

What STDs are reportable?

STI and HIV/AIDS cases should be reported in ance with state and local statutory requirements. Syphilis (including congenital syphilis), gonorrhea, chlamydia, chancroid, and HIV are reportable diseases in every state.

Is salmonella a notifiable disease?

Salmonellosis is a nationally notifiable disease. We monitor cases through the National Notifiable Diseases Surveillance System (NNDSS) and report data in our salmonella public dataset.

What are reportable diseases in NC?

Reportable Diseases AIDS. Anthrax* Botulism. Brucellosis. Campylobacter. Cholera. Chlamydia. COVID-19.

Is chlamydia a reportable disease in NC?

Immediate reporting is required for potential bioterrorism-related diseases, such as anthrax and botulism; the severe or highly communicable diseases, such as cholera and cryptosporidiosis, must be reported within 24 hours of diagnosis; other diseases and conditions, such as mumps and chlamydia, have a seven-day

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What is DHHS 2124?

DHHS 2124 is a form used by the Department of Health and Human Services to report specific data related to health programs or services.

Who is required to file DHHS 2124?

Entities receiving funding from the Department of Health and Human Services or those required to report health data as stipulated by DHHS guidelines must file DHHS 2124.

How to fill out DHHS 2124?

To fill out DHHS 2124, follow the provided instructions carefully, ensuring that all required fields are completed accurately, and submit the form by the specified deadline.

What is the purpose of DHHS 2124?

The purpose of DHHS 2124 is to collect essential data on health services and programs to evaluate their effectiveness and ensure accountability in the use of funds.

What information must be reported on DHHS 2124?

Reports on DHHS 2124 must include information such as program outcomes, participant demographics, service delivery metrics, and financial expenditures related to the funded programs.