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FISTULA RELIEFGRANT REQUEST FORM O U N D AT I O N F O R AFRICA For the Reclamation of Life. O. B o × 4 8 5Bentonville, AR 72712info stularelief.org Date: Name: Title: Organization: Address: E Mail:
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A fistula is an abnormal connection between two body parts that are not normally connected.
Healthcare professionals are required to report cases of fistula.
The form for reporting a fistula usually requires information such as patient demographics, medical history, and details of the fistula.
The purpose of reporting a fistula is to track cases, provide appropriate treatment, and prevent further complications.
Information like the type of fistula, location, size, symptoms, and treatment provided are typically required to be reported.
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