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Fax Page 1 To:Adapted from WA DOH Form 347102Stevens County / NE County Health District (509× 6849878 (Confidential FAX line×CONFIDENTIAL SEXUALLY TRANSMITTED DISEASE CASE REPORT STDs within three

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Those who are required to fill out an adapted form from the Washington Department of Health (WA DOH) are individuals who need to provide specific information or complete certain actions as mandated by the relevant regulations or authorities governed by the WA DOH. The exact criteria and circumstances may vary depending on the specific form and its purpose.

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Adapted from WA DOH refers to documents or forms that have been modified or customized based on Washington State Department of Health guidelines.

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The specific information to be reported on adapted from WA DOH forms will depend on the type of form and the requirements set by the Washington State Department of Health.

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