Get the free Syphilis Serology DHHS 3446 - State Laboratory of Public Health

1 1. Last Name First Name MI 2. Patient Number DO NOT WRITE IN THIS SPACE LABORATORY NUMBER N.C. Department of Health and Human Services State Laboratory of Public Health 4312 District Drive P.O.

How to fill out syphilis serology dhhs 3446

The syphilis serology DHHS 3446 form is typically used by healthcare professionals to document and report the results of serological testing for syphilis. Here's a step-by-step guide on how to fill out the form, along with an explanation of who needs to use it:

1. Date and time: Begin by entering the date and time when the form is being filled out. This helps provide a reference for when the tests were conducted.
2. Patient information: Fill in the patient's personal information, including their full name, date of birth, and gender. This ensures that the results are linked to the correct individual.
3. Specimen information: Provide details about the specimen being tested, such as its source (e.g., blood, cerebrospinal fluid) and the date it was collected. This helps in sample identification and tracking.
4. Clinical information: Include relevant clinical information about the patient, such as signs and symptoms, medical history, and the reason for ordering the test. This aids in the interpretation of the test results.
5. Ordering physician information: Enter the name, contact information, and identification number (if applicable) of the healthcare professional who ordered the test. This allows for communication or follow-up if necessary.
6. Testing information: Specify the type of serological testing performed for syphilis, along with the laboratory where the testing was conducted. Include details like the date the test was performed, method used, and any additional remarks or observations.
7. Test results: Record the results of each specific serological test conducted for syphilis. This may include the results for treponemal and non-treponemal tests, such as RPR (rapid plasma reagin) or TPPA (Treponema pallidum particle agglutination assay).
8. Interpretation: Based on the test results and clinical context, provide an interpretation of the findings. This could be specified as positive, negative, reactive, non-reactive, or equivocal. Any additional notes or remarks can also be included here.
9. Reporting institution: Indicate the name, address, and contact information of the facility or institution that is reporting the results. This ensures proper identification and facilitates further communication if required.

Who needs syphilis serology dhhs 3446?

Healthcare professionals involved in the diagnosis and management of patients suspected or confirmed to have syphilis typically use the syphilis serology DHHS 3446 form. This could include physicians, nurses, laboratory technicians, or other qualified healthcare providers. The form helps in documenting and communicating the results of serological testing, which is crucial for patient care and public health surveillance of syphilis infections.

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What is syphilis serology dhhs 3446?

Syphilis serology dhhs 3446 is a form used for reporting syphilis test results to the Department of Health and Human Services.

Who is required to file syphilis serology dhhs 3446?

Healthcare providers and laboratories are required to file syphilis serology dhhs 3446.

How to fill out syphilis serology dhhs 3446?

Syphilis serology dhhs 3446 should be filled out with the patient's information and test results, then submitted to the DHHS.

What is the purpose of syphilis serology dhhs 3446?

The purpose of syphilis serology dhhs 3446 is to track and monitor syphilis cases for public health purposes.

What information must be reported on syphilis serology dhhs 3446?

The form requires information such as patient demographics, test results, date of testing, and provider information.