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SHORT OUTBREAK REPORTING FORM Use this form for outbreaks reported that are caused by a pathogen that is not individually reportable per ARM 37.114.203. (i.e. scabies, head lice, HMD). For all other

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How to fill out short outbreak reporting form

01

Step 1: Obtain a copy of the short outbreak reporting form from the appropriate health department or organization.

02

Step 2: Fill out the basic information section, including the name of the facility or location where the outbreak occurred, the date of the outbreak, and the number of individuals affected.

03

Step 3: Provide details about the outbreak, including the symptoms experienced by those affected, any laboratory test results, and any known or suspected sources of the outbreak.

04

Step 4: Submit the completed form to the designated recipient within the specified timeframe.

Who needs short outbreak reporting form?

01

Healthcare facilities

02

Public health departments

03

Government agencies

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What is short outbreak reporting form?

The short outbreak reporting form is a streamlined document used to quickly report infectious disease outbreaks to health authorities.

Who is required to file short outbreak reporting form?

Health care providers, laboratories, and public health officials are typically required to file the short outbreak reporting form when they identify an outbreak.

How to fill out short outbreak reporting form?

To fill out the short outbreak reporting form, you should provide detailed information regarding the outbreak, including affected individuals, symptoms, and any possible sources of infection.

What is the purpose of short outbreak reporting form?

The purpose of the short outbreak reporting form is to facilitate rapid communication of outbreak information to prevent further spread and ensure appropriate response measures.

What information must be reported on short outbreak reporting form?

The information that must be reported includes the type of outbreak, number of cases, demographics of affected individuals, location, and any preliminary investigation findings.

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