Get the free COVID-19 CASE RECORD FORM RAPID version 8APR2020

Get Form

Show details

COVID19Patient Screening Format (mm/dd/YYY): ___ Staff screener: ___ Name (First/Last): ___ Patient age: ___ Who answered:Patienter (Specify): ___Contact Method:PhoneEmailContact Info:Other: ___Mobile:

We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign covid-19 case record form

Edit your covid-19 case record form form online

Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature

Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly

Email, fax, or share your covid-19 case record form form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing covid-19 case record form online

Ease of Setup

pdfFiller User Ratings on G2

Ease of Use

pdfFiller User Ratings on G2

To use the professional PDF editor, follow these steps below:

1

Set up an account. If you are a new user, click Start Free Trial and establish a profile.

2

Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.

3

Edit covid-19 case record form. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.

4

Save your file. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.

pdfFiller makes dealing with documents a breeze. Create an account to find out!

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.

Learn more about security & compliance

How to fill out covid-19 case record form

01

Start by entering the patient's personal information such as name, age, and contact details.

02

Record the date of symptom onset and any relevant medical history.

03

Document the details of the patient's exposure to COVID-19, including recent travel history or contact with known cases.

04

Record the results of any COVID-19 tests conducted on the patient.

05

Note down any symptoms experienced by the patient and their severity.

06

Include any treatment provided to the patient for COVID-19.

07

Finally, ensure all sections of the form are accurately filled out and signed by the appropriate healthcare professional.

Who needs covid-19 case record form?

01

Healthcare providers

02

Public health agencies

03

Employers implementing COVID-19 protocols at workplaces

Fill form : Try Risk Free

Rate the form

4.6

Satisfied

56 Votes

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

Can I create an electronic signature for signing my covid-19 case record form in Gmail?

Create your eSignature using pdfFiller and then eSign your covid-19 case record form immediately from your email with pdfFiller's Gmail add-on. To keep your signatures and signed papers, you must create an account.

How do I complete covid-19 case record form on an iOS device?

pdfFiller has an iOS app that lets you fill out documents on your phone. A subscription to the service means you can make an account or log in to one you already have. As soon as the registration process is done, upload your covid-19 case record form. You can now use pdfFiller's more advanced features, like adding fillable fields and eSigning documents, as well as accessing them from any device, no matter where you are in the world.

How do I complete covid-19 case record form on an Android device?

On Android, use the pdfFiller mobile app to finish your covid-19 case record form. Adding, editing, deleting text, signing, annotating, and more are all available with the app. All you need is a smartphone and internet.

What is covid-19 case record form?

The covid-19 case record form is a document used to record information about confirmed or suspected cases of covid-19.

Who is required to file covid-19 case record form?

Healthcare facilities, employers, and public health authorities are required to file the covid-19 case record form.

How to fill out covid-19 case record form?

The covid-19 case record form can be filled out by providing details such as the patient's name, contact information, date of birth, symptoms, test results, and dates of diagnosis and treatment.

What is the purpose of covid-19 case record form?

The purpose of the covid-19 case record form is to track and monitor confirmed or suspected cases of covid-19 for public health and safety.

What information must be reported on covid-19 case record form?

Information such as patient demographics, symptoms, test results, dates of diagnosis and treatment, and contact information must be reported on the covid-19 case record form.

Fill out your covid-19 case record form online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now