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Ebola Virus Disease (END) Assessment Format: Clinician Contact Information Last name: First name: Address: Town/City : Province/Territory: Postal code: Phone number (s) (), () Patient Information
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Start by gathering all the necessary information and documents.
02
Begin by filling out the personal details section, which includes your full name, date of birth, and contact information.
03
Move on to the medical history section and provide accurate information about any previous illnesses or medical conditions.
04
Fill in the travel history section, detailing any recent trips or visits to regions affected by the Ebola virus.
05
Complete the symptom screening section by indicating any relevant symptoms you may be experiencing.
06
Proceed to the contact information section, providing details of your emergency contact person.
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Review all the information you have provided and ensure its accuracy.
08
Sign and date the form to complete the filling out process.
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Submit the filled-out EVD form to the appropriate authorities or healthcare provider.

Who needs ebola virus disease evd?

01
Anyone who suspects they may have been exposed to the Ebola virus or is experiencing symptoms related to EVD needs to fill out the Ebola Virus Disease form.
02
Individuals who have recently traveled to regions affected by the Ebola virus also need to fill out this form to help healthcare providers in identifying potential cases and taking appropriate actions.
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Ebola Virus Disease (EVD) is a severe and often fatal illness caused by the Ebola virus.
Healthcare providers and facilities are required to file Ebola Virus Disease (EVD) reports.
Ebola Virus Disease (EVD) reports can be filled out electronically or on paper forms provided by the relevant health authorities.
The purpose of Ebola Virus Disease (EVD) reporting is to track and monitor outbreaks of the disease for public health response.
Information such as patient demographics, symptoms, laboratory test results, and potential exposures must be reported on Ebola Virus Disease (EVD) reports.
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