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NJ DOH LEPTOSPIROSIS INVESTIGATION WORKSHEETCDRSS #: ___DEMOGRAPHICS
Patient Name Date of Births ex___ / ___ / ___AddressPhone lumberjack
White
Black
Other___ American Indian or Alaskan NativeEthnicity
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How to fill out njdoh leptospirosis investigation worksheet
How to fill out njdoh leptospirosis investigation worksheet
01
Obtain a copy of the NJDOH Leptospirosis Investigation Worksheet.
02
Fill in all required fields such as patient information, symptoms, potential exposure sources, and laboratory results.
03
Provide as much detail as possible about the patient's condition and potential sources of exposure.
04
Submit the completed worksheet to the appropriate health department or agency as instructed.
Who needs njdoh leptospirosis investigation worksheet?
01
Healthcare providers investigating suspected cases of leptospirosis
02
Public health officials monitoring and tracking cases of leptospirosis in the community
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What is njdoh leptospirosis investigation worksheet?
The njdoh leptospirosis investigation worksheet is a form used to report cases of leptospirosis to the New Jersey Department of Health.
Who is required to file njdoh leptospirosis investigation worksheet?
Healthcare providers, laboratories, and public health officials are required to file the njdoh leptospirosis investigation worksheet.
How to fill out njdoh leptospirosis investigation worksheet?
The njdoh leptospirosis investigation worksheet can be filled out by providing information about the case, including symptoms, exposure history, and laboratory test results.
What is the purpose of njdoh leptospirosis investigation worksheet?
The purpose of the njdoh leptospirosis investigation worksheet is to track and investigate cases of leptospirosis in order to prevent further spread of the disease.
What information must be reported on njdoh leptospirosis investigation worksheet?
Information such as patient demographics, symptoms, exposure history, and laboratory test results must be reported on the njdoh leptospirosis investigation worksheet.
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