AZ ADHS Rabies Risk Assessment & Laboratory Submission Form 2021-2025 free printable template

RABIES RISK ASSESSMENT & LABORATORY SUBMISSION FORM To: AZ DHS Rabies Team BZD AIDS.phone (602) 364 3676 Fax (602) 364 3198County: Submitter Agency: Contact Name: Address: City: St: Zip: Phone: Email:

How to fill out rabies risk assessment form

How to fill out AZ ADHS Rabies Risk Assessment & Laboratory

1. Begin by obtaining the AZ ADHS Rabies Risk Assessment & Laboratory form from the appropriate website or office.
2. Fill out the personal information section, including your name, contact information, and date of birth.
3. Provide details about the exposure incident, including the date, time, and location of the potential rabies exposure.
4. Describe the type of exposure (e.g., bite, scratch) and the animal involved, including species and vaccination status if known.
5. Indicate any clinical signs observed in the animal or any risk factors associated with the incident.
6. Complete the section regarding your medical history, focusing on any previous rabies vaccinations.
7. Review the completed form for accuracy and ensure all required fields are filled out.
8. Submit the form as instructed, either electronically or in person, to the proper authority or laboratory.

Who needs AZ ADHS Rabies Risk Assessment & Laboratory?

1. Individuals who have potentially been exposed to rabies through bites or scratches from rabid animals.
2. Healthcare professionals needing to assess rabies risk after an exposure incident.
3. Pet owners and animal control officers who need to report animal bites or rabies exposure.
4. Veterinarians who suspect rabies in an animal or are involved in the follow-up of rabies exposure cases.

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What is AZ ADHS Rabies Risk Assessment & Laboratory?

The AZ ADHS Rabies Risk Assessment & Laboratory is a framework established by the Arizona Department of Health Services to evaluate the risk of rabies exposure and provide laboratory testing for potential rabies cases.

Who is required to file AZ ADHS Rabies Risk Assessment & Laboratory?

Individuals who have potentially been exposed to rabies, including healthcare providers, animal control officers, and public health officials are required to file the AZ ADHS Rabies Risk Assessment & Laboratory.

How to fill out AZ ADHS Rabies Risk Assessment & Laboratory?

To fill out the AZ ADHS Rabies Risk Assessment & Laboratory, individuals must provide details regarding the exposure incident, including the type of exposure, the animal involved, and the vaccination status of the animal.

What is the purpose of AZ ADHS Rabies Risk Assessment & Laboratory?

The purpose of the AZ ADHS Rabies Risk Assessment & Laboratory is to assess potential rabies exposures, guide post-exposure prophylaxis decisions, and ensure the appropriate testing of animals suspected of carrying rabies.

What information must be reported on AZ ADHS Rabies Risk Assessment & Laboratory?

The information that must be reported includes details of the exposure (date, time, location), the species of the animal involved, the vaccination status of the animal, and any symptoms observed in the animal.