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How to fill out the Epid 200 online
The Epid 200 form is essential for reporting various diseases to the local health departments in Kentucky. This guide will walk you through each section of the form, providing clear instructions to ensure accurate completion.
Follow the steps to successfully fill out the Epid 200 form online.
- Press the ‘Get Form’ button to access the Epid 200 form and open it in your chosen online editor.
- Begin by filling out the patient’s last name in the designated field. Next, enter the middle initial and first name as required.
- Provide the patient’s demographic data, including their date of birth, address, city, state, zip code, phone number, patient ID number, age, ethnicity, race, and gender. Ensure all fields are accurately completed.
- In the disease information section, specify the disease or organism the patient is diagnosed with, along with the date of onset, date of diagnosis, highest temperature recorded, and any listed symptoms or comments.
- Indicate whether the patient was hospitalized by selecting 'Yes' or 'No'. If hospitalized, provide the admission and discharge dates, along with the hospital name.
- If applicable, note whether the patient is pregnant and whether there is any school or daycare association, including the relevant names.
- Complete the laboratory information section by entering the name of the laboratory, the specimen source, and details regarding date of specimen collection and results.
- If reporting on sexually transmitted diseases, fill in additional fields relevant to disease detection method, stage, treatment details, and any resistance encountered.
- Review all completed fields for accuracy and completeness. Once satisfied, proceed to save changes, download, print, or share the completed Epid 200 form as required.
Start filling out your Epid 200 form online today!
Reportable specified diseases include a range of conditions mandated by Kentucky law that require health professionals to notify authorities. These diseases are identified for their potential impact on public health. With Epid 200, you can efficiently manage your reporting responsibilities for these diseases, ensuring you meet legal requirements while contributing to health safety.
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