Get the free Infectious Disease Visitor Screening Form - childrensomaha

Anyone who is ill or has been exposed to contagious diseases should not visit the hospital! This is for the protection of our patients! Infectious Disease Visitor Screening Form Directions: Complete

How to fill out infectious disease visitor screening

How to fill out infectious disease visitor screening:

1. Locate the infectious disease visitor screening form. It is typically provided by the facility or organization you are visiting.
2. Read the instructions carefully to understand the purpose and requirements of the screening.
3. Begin by filling out your personal information, including your name, contact details, and any other requested identification information.
4. Provide details about your recent travel history. This may include information such as countries or regions visited, dates of travel, and modes of transportation used.
5. Answer questions about any symptoms you may be experiencing. Common symptoms to look out for include fever, cough, shortness of breath, body aches, sore throat, and fatigue.
6. Indicate whether you have had close contact with someone who has a confirmed or suspected infectious disease. Close contact typically refers to being within six feet of an infected person for a prolonged period.
7. Disclose if you have tested positive for any infectious diseases in the past, or if you are currently under investigation for a potential infectious disease.
8. Provide any additional information or comments that may be requested, such as specific concerns or circumstances that you believe are relevant to the screening.
9. Review your answers to ensure accuracy and completeness.
10. Sign and date the form to verify that the information provided is true and correct.

Who needs infectious disease visitor screening?

1. Individuals who are planning to visit healthcare facilities, nursing homes, or other high-risk environments may be required to undergo infectious disease visitor screening.
2. Visitors to countries or regions with known infectious disease outbreaks may also be subjected to screening measures upon arrival or departure.
3. Additionally, individuals who have been in close contact with someone diagnosed with an infectious disease may be required to undergo screening as a precautionary measure.

For pdfFiller’s FAQs

What is infectious disease visitor screening?

Infectious disease visitor screening is the process of evaluating visitors for potential infectious diseases before allowing them to enter a certain premises or facility.

Who is required to file infectious disease visitor screening?

Anyone responsible for managing the premises or facility where the screening is being conducted is required to file infectious disease visitor screening.

How to fill out infectious disease visitor screening?

To fill out infectious disease visitor screening, one must gather information about the visitor's recent travel history, symptoms, and potential exposure to infectious diseases.

What is the purpose of infectious disease visitor screening?

The purpose of infectious disease visitor screening is to prevent the spread of infectious diseases within a premises or facility by identifying and isolating potentially infected individuals.

What information must be reported on infectious disease visitor screening?

Information such as the visitor's travel history, symptoms, and potential exposure to infectious diseases must be reported on infectious disease visitor screening.

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