FL Confidential Report of Sexually Transmitted Diseases - Seminole County 2013 free printable template
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STD Surveillance FLORIDA CONFIDENTIAL REPORT OF SEXUALLY TRANSMITTED DISEASES Florida Department of Health in Seminole County 400 W Airport Blvd Sanford, FL 32773 Phone: (407) 665-3285 or (407) 665-3286
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How to fill out FL Confidential Report of Sexually Transmitted Diseases
How to fill out FL Confidential Report of Sexually Transmitted Diseases
01
Obtain the FL Confidential Report of Sexually Transmitted Diseases form from a healthcare provider or the Florida Department of Health website.
02
Fill out the patient's personal information, including name, address, and date of birth.
03
Indicate the type of sexually transmitted disease (STD) being reported.
04
Document the date of diagnosis and any relevant symptoms or clinical findings.
05
Enter information about the healthcare provider who diagnosed the STD, including their name and contact information.
06
Complete any additional sections required by the form, such as treatment information and partner notification details.
07
Review the form for accuracy and completeness.
08
Sign and date the completed form before submission.
09
Submit the report to the appropriate local health department or designated authority as instructed.
Who needs FL Confidential Report of Sexually Transmitted Diseases?
01
Healthcare providers treating patients diagnosed with sexually transmitted diseases.
02
Public health officials responsible for monitoring and controlling the spread of STDs.
03
Patients diagnosed with STDs for follow-up care and partner notification purposes.
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What is FL Confidential Report of Sexually Transmitted Diseases?
The FL Confidential Report of Sexually Transmitted Diseases is a document used in Florida to report cases of sexually transmitted infections (STIs) to health authorities for monitoring and public health purposes.
Who is required to file FL Confidential Report of Sexually Transmitted Diseases?
Healthcare providers, including doctors and clinics, who diagnose or treat patients with sexually transmitted diseases are required to file the FL Confidential Report of Sexually Transmitted Diseases.
How to fill out FL Confidential Report of Sexually Transmitted Diseases?
The report must be filled out by providing patient demographics, details of the diagnosis, treatment information, and the healthcare provider's contact and reporting information. It should be submitted according to the guidelines set by the Florida Department of Health.
What is the purpose of FL Confidential Report of Sexually Transmitted Diseases?
The purpose of the FL Confidential Report of Sexually Transmitted Diseases is to collect data on the incidence and prevalence of STIs to inform public health strategies, monitor trends, and facilitate prevention efforts.
What information must be reported on FL Confidential Report of Sexually Transmitted Diseases?
Information that must be reported includes patient name, date of birth, gender, race, address, type of STI diagnosed, date of diagnosis, treatment provided, and any relevant clinical information.
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