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Notification of Suspected Gonorrhea Treatment Failure Form for LHJsUpload this form to the Cardie incidents electronic filing cabinet and inform stdcb_argc@cdph.ca.gov within 24 hours A patient who

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How to fill out notification of suspected gonorrhea

01

Obtain a notification of suspected gonorrhea form from a healthcare provider or local health department.

02

Fill out personal information including name, date of birth, contact information, and any relevant medical history.

03

Provide details about the suspected gonorrhea exposure including date, location, and potential source.

04

Submit the completed form to the appropriate healthcare provider or local health department for further evaluation and testing.

Who needs notification of suspected gonorrhea?

01

Anyone who has been diagnosed with or is suspected to have gonorrhea.

02

Sexual partners of individuals diagnosed with or suspected to have gonorrhea.

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What is notification of suspected gonorrhea?

Notification of suspected gonorrhea is a process where healthcare providers are required to report any suspected cases of gonorrhea to the appropriate health authorities.

Who is required to file notification of suspected gonorrhea?

Healthcare providers, including doctors, nurses, and laboratories, are required to file notification of suspected gonorrhea.

How to fill out notification of suspected gonorrhea?

Healthcare providers can fill out the notification of suspected gonorrhea form online or submit it via fax or mail to the designated health department.

What is the purpose of notification of suspected gonorrhea?

The purpose of notification of suspected gonorrhea is to track and monitor the spread of gonorrhea in the community, so that appropriate public health measures can be taken.

What information must be reported on notification of suspected gonorrhea?

The information that must be reported on notification of suspected gonorrhea includes the patient's demographic information, test results, and any relevant medical history.

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