Get the free NJDOH EBOLA INVESTIGATION WORKSHEET

NJ DOH EBOLA INVESTIGATION WORKSHEET MR #: CD RSS #: Submit with all laboratory test results via encrypted email to CDSVectorTeam DOH.NJ.gov or fax to 6098264874. Questions? Call 6098265964. Demographics

How to fill out njdoh ebola investigation worksheet

How to fill out njdoh ebola investigation worksheet

1. To fill out NJDOH Ebola investigation worksheet, follow the steps below:
2. Start by gathering all the necessary information about the suspected Ebola case, including the individual's personal details, symptoms, and travel history.
3. Complete the 'Patient Information' section of the worksheet, providing the individual's full name, date of birth, address, and contact information.
4. Move on to the 'Symptoms' section and check all the applicable symptoms the person is experiencing.
5. If the person has a fever, indicate the temperature in the provided space.
6. In the 'Travel History' section, record the countries the person has visited in the past 21 days.
7. Specify the dates of travel for each country and whether the person had any direct contact with Ebola patients or their bodily fluids during the trip.
8. Provide details about any healthcare facilities visited by the individual since the onset of symptoms, including name, location, and dates.
9. Answer the additional questions related to exposure risks, such as whether the person had contact with animals, healthcare workers, or attended large gatherings.
10. If the individual has been tested for Ebola, indicate the date and results of the test.
11. Finally, make sure to sign and date the worksheet to confirm its accuracy.
12. Remember to review the completed worksheet for any errors or missing information before submitting it.

Who needs njdoh ebola investigation worksheet?

1. The NJDOH Ebola investigation worksheet is needed by healthcare professionals and authorities responsible for monitoring and responding to potential Ebola cases.
2. It is typically used in healthcare settings, such as hospitals, clinics, and public health departments, where suspected Ebola cases are assessed and investigated.
3. These professionals need the worksheet to accurately collect and document information about the suspected cases, enabling proper evaluation, surveillance, and appropriate measures to prevent the spread of Ebola virus.

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What is njdoh ebola investigation worksheet?

The NJDOH Ebola Investigation Worksheet is a document used by the New Jersey Department of Health to collect information about potential Ebola virus disease cases for epidemiological investigation.

Who is required to file njdoh ebola investigation worksheet?

Healthcare providers, laboratories, and other entities that suspect a case of Ebola virus disease are required to file the NJDOH Ebola Investigation Worksheet.

How to fill out njdoh ebola investigation worksheet?

The NJDOH Ebola Investigation Worksheet should be filled out by providing relevant patient information, clinical details, exposure history, and travel history as per the instructions provided on the form.

What is the purpose of njdoh ebola investigation worksheet?

The purpose of the NJDOH Ebola Investigation Worksheet is to facilitate the rapid identification and response to potential Ebola cases to prevent the spread of the virus.

What information must be reported on njdoh ebola investigation worksheet?

Information such as patient demographics, clinical symptoms, potential exposures, and travel history must be reported on the NJDOH Ebola Investigation Worksheet.