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Fax Page 1 To:Adapted from WA DOH
Form 347102Whitman County Health Department
confidential SEXUALLY TRANSMITTED INFECTION CASE REPORT STIs within 3 work days (WAC 246101101/301)
PATIENT INFORMATION
LAST
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How to fill out confidential sexually transmitted disease
How to fill out confidential sexually transmitted disease
01
Start by learning about the specific sexually transmitted disease that you need to fill out information for.
02
Obtain the necessary forms from a healthcare provider or clinic.
03
Fill out all personal information accurately and completely.
04
Provide detailed information on your sexual history and any symptoms you may be experiencing.
05
Be honest and open about your situation to ensure proper treatment and care.
06
Return the completed forms to the healthcare provider or clinic as instructed.
Who needs confidential sexually transmitted disease?
01
Anyone who has been diagnosed with a sexually transmitted disease and needs to provide information for treatment and monitoring purposes.
02
People who suspect they may have a sexually transmitted disease and are seeking testing and treatment.
03
Healthcare providers and clinics who need accurate and confidential information for patient care.
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What is confidential sexually transmitted disease?
Confidential sexually transmitted diseases are infections that are transmitted from one person to another through sexual contact and are considered sensitive and private information.
Who is required to file confidential sexually transmitted disease?
Healthcare providers and laboratories are required to report confidential sexually transmitted diseases to public health authorities.
How to fill out confidential sexually transmitted disease?
Confidential sexually transmitted disease reports can be filled out electronically or on paper forms provided by public health authorities.
What is the purpose of confidential sexually transmitted disease?
The purpose of reporting confidential sexually transmitted diseases is to track and monitor the spread of infections in order to implement prevention and treatment measures.
What information must be reported on confidential sexually transmitted disease?
Information such as the type of infection, date of diagnosis, demographic data of the infected individual, and risk factors may be required to be reported on confidential sexually transmitted disease forms.
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