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How to fill out the Dhec 1129 Form online
The Dhec 1129 Form is a vital document for disease reporting required by the South Carolina Department of Health and Environmental Control. Filling out this form online can seem daunting, but with clear guidance, you can successfully complete it to ensure proper reporting.
Follow the steps to fill out the Dhec 1129 Form online effectively.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- Begin filling out the disease/condition field by providing the necessary details including the stage if appropriate, followed by today's date.
- Complete the personal identification section, including the last name, first name, and any middle name of the individual reported. Select the appropriate ethnicity and sex from the provided options.
- If the individual is female, indicate whether they are pregnant by selecting yes, no, or unknown.
- Input the patient ID or the last five digits of the Social Security Number, along with the date of birth.
- Provide the race of the individual from the available options, and fill in the street address, city, state, zip code, and county.
- Enter the preferred contact number, specifying whether it is a home or cell number.
- Indicate the date of symptom onset and record any symptoms experienced.
- Note the hospitalization status by selecting yes, no, or unknown, and provide details if hospitalized such as admission and discharge dates.
- Fill in the laboratory information, including specimen collection date and results.
- Complete the reporter information section carefully, ensuring to include comments if necessary.
- After entering all required information, review the form for accuracy. You can then save changes, download, print, or share the completed form as needed.
Take the next step in disease reporting—complete the Dhec 1129 Form online today!
The CDC requires the reporting of various diseases, including gonorrhea, HIV/AIDS, and prominent viral infections. This reporting is vital to track public health concerns and manage outbreaks effectively. By using the Dhec 1129 Form, healthcare professionals can ensure they are following CDC guidelines and contributing to broader public health initiatives.
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