IL Confidential Morbidity Report of Sexually Transmitted Infections 2022-2025 free printable template
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DraftILLINOIS DEPARTMENT OF PUBLIC HEALTH
ILLINOIS CONFIDENTIAL MORBIDITY REPORT OF SEXUALLY TRANSMITTED INFECTIONSPATIENT INFORMATION
Expedited Partner Therapy (EPT) given
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How to fill out IL Confidential Morbidity Report of Sexually Transmitted Infections
01
Obtain the IL Confidential Morbidity Report form from the appropriate health department website or office.
02
Fill out the patient's personal information, including name, address, date of birth, and gender.
03
Provide information regarding the type of sexually transmitted infection (STI) diagnosed.
04
Indicate the date of diagnosis and any relevant clinical information.
05
Include details of the healthcare provider making the report, including name, contact information, and facility name.
06
Complete sections related to partner treatment, if applicable.
07
Review the form for accuracy and completeness.
08
Submit the report to the local health department as instructed.
Who needs IL Confidential Morbidity Report of Sexually Transmitted Infections?
01
Healthcare providers diagnosing STIs.
02
Laboratories that perform STI testing.
03
Public health officials monitoring STI trends.
04
Researchers studying the epidemiology of STIs.
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What is IL Confidential Morbidity Report of Sexually Transmitted Infections?
The IL Confidential Morbidity Report of Sexually Transmitted Infections is a state-mandated form used to report cases of sexually transmitted infections (STIs) to public health authorities in Illinois. This report helps track the incidence and prevalence of STIs for public health monitoring and intervention.
Who is required to file IL Confidential Morbidity Report of Sexually Transmitted Infections?
Healthcare providers, including physicians, clinics, and laboratories that diagnose or treat sexually transmitted infections in patients are required to file the IL Confidential Morbidity Report.
How to fill out IL Confidential Morbidity Report of Sexually Transmitted Infections?
To fill out the IL Confidential Morbidity Report, healthcare providers must include information such as the patient's demographics, the type of STI diagnosed, date of diagnosis, treatment provided, and any other relevant clinical information as specified in the reporting guidelines.
What is the purpose of IL Confidential Morbidity Report of Sexually Transmitted Infections?
The purpose of the IL Confidential Morbidity Report is to collect data on the incidence of sexually transmitted infections, which aids in public health surveillance, prevention efforts, and allocation of resources to combat the spread of STIs.
What information must be reported on IL Confidential Morbidity Report of Sexually Transmitted Infections?
The report must include information such as the patient's name, address, birth date, sex, race, ethnicity, the type of STI, date of diagnosis, treatment provided, and any other information as required by state health regulations.
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