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Get the free Michigan Interim COVID-19 PUI Case Report Form 4.14.20 1-page PRE-SURGICAL copy

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Michigan Interim COVID-19 Person Under Investigation (PUB) Case Report Form Patient Information: First name:Last name:Date of birth://Age:Sex:Patient residence street address: County:FemaleMaleCity:
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How to fill out michigan interim covid-19 pui

01
Fill out personal information including name, address, date of birth, and contact information.
02
Provide information on symptoms you are experiencing related to COVID-19.
03
Answer questions about recent travel history and exposure to individuals with COVID-19.
04
Follow instructions on submitting the filled out form as per the guidelines provided by the Michigan health department.

Who needs michigan interim covid-19 pui?

01
Individuals who are experiencing symptoms of COVID-19 and suspect they may have been exposed to the virus.
02
Healthcare providers who are treating patients with suspected or confirmed cases of COVID-19.
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Michigan Interim COVID-19 PUI stands for Michigan Interim COVID-19 Person Under Investigation.
Healthcare facilities and providers are required to file Michigan Interim COVID-19 PUI reports.
Michigan Interim COVID-19 PUI can be filled out electronically through the designated reporting system provided by the Michigan Department of Health and Human Services.
The purpose of Michigan Interim COVID-19 PUI is to track and monitor potential cases of COVID-19 in Michigan to help prevent the spread of the virus.
Information such as patient demographics, symptoms, exposure history, and test results must be reported on Michigan Interim COVID-19 PUI.
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