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Fax Page 1 To:Adapted from WA DOH Form 347102Yakima Health District(509) 3813526 (Confidential FAX line)CONFIDENTIAL SEXUALLY TRANSMITTED DISEASE CASE REPORT STDs within three work days (WAC 246101101/301)PATIENT
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How to fill out std case reporting form
How to fill out std case reporting form
01
Obtain a copy of the STD case reporting form from your local health department or online.
02
Fill out the patient's demographics, including name, date of birth, and contact information.
03
Provide information about the STD diagnosis, including date of diagnosis, type of STD, and treatment received.
04
Include any relevant medical history or risk factors for the STD.
05
Submit the completed form to the appropriate health department or reporting agency.
Who needs std case reporting form?
01
Healthcare providers who diagnose and treat patients with STDs.
02
Laboratories that conduct STD testing and report positive results.
03
Public health officials who track and monitor STD outbreaks and trends.
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What is std case reporting form?
The std case reporting form is a document used to report cases of sexually transmitted diseases.
Who is required to file std case reporting form?
Healthcare providers and facilities are required to file std case reporting form.
How to fill out std case reporting form?
To fill out the std case reporting form, provide details about the patient, the diagnosis, and the treatment received.
What is the purpose of std case reporting form?
The purpose of std case reporting form is to monitor and track cases of sexually transmitted diseases for public health purposes.
What information must be reported on std case reporting form?
Information such as patient demographics, diagnosis, treatment, and follow-up care must be reported on std case reporting form.
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