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INFECTIOUS SYPHILIS NOTIFICATION FORM This is a Schedule 1, Section C disease notifiable to the Medical Officer of Health under Sections 74 and 74AA of the Health Act 1956 using nonidentifiable data.
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How to fill out infectious syphilis notification form
How to fill out infectious syphilis notification form
01
To fill out the infectious syphilis notification form, follow these steps:
02
Begin by providing your personal information, such as your name, contact details, and job title, if applicable.
03
Fill in the details of the infected person, including their name, contact information, and any other relevant identification details.
04
Specify the healthcare facility or institution where the infected person received diagnosis or treatment for syphilis.
05
Indicate the date when the person was diagnosed with syphilis.
06
Provide information about the type of syphilis infection (primary, secondary, or latent) and any associated symptoms.
07
Include details about the healthcare professional who diagnosed or treated the patient, such as their name, contact information, and job title.
08
If applicable, mention any additional notes or relevant information that may be important for notification purposes.
09
Double-check all the provided information for accuracy and completeness.
10
Submit the filled-out infectious syphilis notification form through the designated channel or to the appropriate authority.
Who needs infectious syphilis notification form?
01
The infectious syphilis notification form is required by healthcare professionals, medical institutions, and laboratories involved in the diagnosis, treatment, and monitoring of syphilis cases.
02
In addition to healthcare providers, public health authorities and regulatory bodies may also require this form for the purpose of disease surveillance and control.
03
Individuals who have been diagnosed with syphilis are not typically the ones responsible for completing the notification form, as it is primarily the responsibility of healthcare providers and institutions to report such cases.
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What is infectious syphilis notification form?
The infectious syphilis notification form is a document used to report cases of syphilis to public health authorities.
Who is required to file infectious syphilis notification form?
Healthcare providers are required to file the infectious syphilis notification form.
How to fill out infectious syphilis notification form?
The form can be filled out electronically or manually by providing information about the patient's demographics, test results, treatment, and contact information.
What is the purpose of infectious syphilis notification form?
The purpose of the infectious syphilis notification form is to track and monitor cases of syphilis, prevent further spread of the disease, and ensure that patients receive appropriate treatment.
What information must be reported on infectious syphilis notification form?
The form typically requires information such as patient name, age, gender, address, test results, treatment received, and contact information.
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