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SUSPECT COVID-19 CASE FORM SEND THIS FORM TO: HRDCOVID19×TULARECOUNTY.CA.GOV PLEASE NOTE: HRD has a new email address and phone number for COVID-19. You can reach us at HRDCOVID19×multicounty.ca.gov
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To fill out the suspect COVID-19 case form, follow these steps:
02
Visit the official website of your local health department or download the form from their website.
03
Provide your personal information, including your full name, contact number, and address.
04
Fill in your symptoms, such as fever, cough, difficulty breathing, sore throat, etc.
05
Mention any recent travel history, including the countries or regions you have visited in the past few weeks.
06
Indicate if you have come into contact with a confirmed COVID-19 patient.
07
Provide details of any existing medical conditions or underlying health conditions you may have.
08
Sign and date the form to verify its authenticity.
09
Submit the completed form to the designated health department via email, fax, or in-person drop-off, as instructed by the authorities.
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Note: The specific instructions and required information may vary depending on your location and the guidelines provided by your local health department.

Who needs suspect covid-19 case form?

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Anyone who suspects they may have contracted COVID-19 or shows symptoms of the virus needs to fill out the suspect COVID-19 case form. This includes individuals who are experiencing symptoms like fever, cough, difficulty breathing, sore throat, etc., or those who have had recent travel history to affected areas or close contact with confirmed COVID-19 patients. The form helps in tracking and monitoring potential cases, ensuring timely testing, and providing necessary medical attention to those in need.
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The suspect covid-19 case form is a document used to report individuals who are showing symptoms or have been exposed to COVID-19.
Healthcare facilities, testing centers, and public health agencies are required to file suspect covid-19 case forms.
The form can be filled out online or submitted through a secure online portal provided by the relevant authorities.
The purpose of the form is to track and monitor potential cases of COVID-19 to help prevent the spread of the virus.
Information such as symptoms, exposure history, test results, and contact information must be reported on the form.
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