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SHOT RECORD REQUEST FORM Patients Full Name: ___ Could this record be recorded under any other name? Yes___ No___ If Yes, Please give that name: ___ Patients Date of Birth: ___ Mothers Full Name:
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How to fill out pertussis reporting and case
How to fill out pertussis reporting and case
01
Collect necessary information such as patient demographics, symptoms, vaccination history, and laboratory test results.
02
Fill out the pertussis reporting form provided by the local health department or CDC.
03
Submit the completed form to the appropriate public health authorities as per the regulations.
Who needs pertussis reporting and case?
01
Healthcare providers
02
Laboratories performing testing for pertussis
03
Local health departments
04
National health agencies
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What is pertussis reporting and case?
Pertussis reporting and case refers to the process of documenting and notifying public health authorities about cases of whooping cough (pertussis) to help monitor and control the disease.
Who is required to file pertussis reporting and case?
Healthcare providers, labs, and public health officials are required to file pertussis reporting and cases when a diagnosis is confirmed.
How to fill out pertussis reporting and case?
Pertussis reporting and case can be filled out using specific forms provided by public health authorities, requiring details such as patient information, diagnosis date, and vaccination history.
What is the purpose of pertussis reporting and case?
The purpose of pertussis reporting and case is to track the incidence of the disease, identify outbreaks, and implement control measures to protect public health.
What information must be reported on pertussis reporting and case?
Information such as patient demographics, symptoms, lab results, vaccination status, and the date of onset must be reported.
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