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Case name (last, first) ___ Birth date ___/___/___Sex at birthFMPhone ___Legionellosis CountyAddress typeHomeMailingOtherAlternate name ___Email ___OtherTemporaryWorkStreet address ___ City/State/Zip/County

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How to fill out reporting form for legionellosis

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Obtain the reporting form for legionellosis

02

Fill out all required information such as patient demographics, symptoms, date of onset, and potential sources of exposure

03

Include any laboratory test results or diagnostic findings related to legionellosis

04

Submit the completed reporting form to the appropriate health authorities or designated reporting agency

Who needs reporting form for legionellosis?

01

Healthcare providers

02

Public health officials

03

Laboratories conducting diagnostic testing for legionellosis

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What is reporting form for legionellosis?

The reporting form for legionellosis is a document used to report cases of legionellosis infection.

Who is required to file reporting form for legionellosis?

Healthcare providers, hospitals, and laboratories are required to file reporting form for legionellosis.

How to fill out reporting form for legionellosis?

The reporting form for legionellosis can be filled out online or submitted in person at the local health department.

What is the purpose of reporting form for legionellosis?

The purpose of the reporting form for legionellosis is to track and monitor cases of legionellosis for public health purposes.

What information must be reported on reporting form for legionellosis?

Information such as patient demographics, symptoms, and laboratory test results must be reported on the reporting form for legionellosis.

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