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It is a form required by the Centers for Disease Control and Prevention (CDC) in Washington, D.C. for reporting public health data.
Healthcare facilities, including hospitals and clinics, are required to file doh101-dc-1002 - cdc gov.
The form can be filled out online through the CDC's reporting portal or submitted via mail.
The purpose of the form is to collect and analyze public health data to track and respond to health trends and outbreaks.
Information such as patient demographics, diagnosis codes, and treatment details must be reported on the form.
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