Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Cdph8554

Get Cdph8554

(Use CDC 52.12 for waterborne disease outbreaks; CDC 52.13 for foodborne disease outbreaks.) OTHER REPORTABLE DISEASE OR DISEASE OF UNUSUAL OCCURRENCE Confirmed Not confirmed Suspected Kind of outbreak/illness PERSONAL DATA FOR SINGLE CASE ONLY Patient name last first middle initial Address number, street City State RACE (check one) Date of birth Age County Sex ZIP code ETHNICITY (check one) African-American/Black White Asian/Pacific Islander Other.

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Cdph8554 online

The Cdph8554 form is crucial for reporting outbreaks and unusual diseases. This guide will provide clear instructions on how to complete the form accurately and efficiently online.

Follow the steps to confidently complete the Cdph8554 form.

  1. Click the ‘Get Form’ button to access the Cdph8554 form and open it for editing.
  2. Begin filling out the personal data section for a single case. Enter the patient's last name, first name, middle initial, address, city, state, race, date of birth, age, county, sex, and ZIP code. Ensure all information is accurate and complete.
  3. Indicate the patient's ethnicity by checking the appropriate box, and if they belong to the Asian/Pacific Islander category, check the specific subgroup.
  4. For outbreaks, fill out the location and scope section, including details such as the city, county, the name of the community or institution, and the population at risk. Record the numbers of persons investigated epidemiologically and those who are ill, along with the dates of onset for the first and last cases.
  5. Document the reason for the investigation, confirming whether the California Department of Public Health was notified.
  6. Provide a history of illness by summarizing the clinical course, characteristics of the epidemic, and incubation periods, along with the outcome of cases.
  7. Detail any diagnostic tests conducted, specifying the type of specimen, the date collected, the type of test performed, and the results.
  8. Conclude by summarizing the results of the investigation, noting probable sources and any additional relevant remarks.
  9. Finally, make sure to fill out the investigator section, providing the investigator's name, date of exposure, date of onset, telephone number, and agency name.
  10. Once you have filled out all the required fields, review the form for accuracy. You may then save your changes, download the completed form, print it, or share it as needed.

Complete the Cdph8554 form online today for efficient outbreak reporting.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

Outbreak - Department of Public Health
Other Outbreaks OR Unusual Disease Report—CDPH 8554—Page 2 of 2. Write in spaces...
Learn more
UC Davis Master of Public Health Overall Practicum...
Ebola AAR for the EPO in CDPH Emergency Prepardness ... 530‐666‐8554 ... Desai...
Learn more

Related links form

MOU And Commitment Chart 2012 - The Greater Long Island Clean ... Application Of The LACE Risk Assessment Tool At Chinese Hospital RELEASE AND HOLD HARMLESS / Talent ... - Amarillo College APPLICATION FOR REINSTATEMENT - Dearborn National

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

California Department of Public Health.

About. Dr. Tomás Aragón serves as the State Public Health Officer and Director, California…

The doctors, nurses, scientists, researchers, public health professionals and staff of CDPH's more than 200 programs display their dedication to public service through our core values: collaboration, competence, equity, integrity, respect, responsibility, trust and vision.

Dr. Mark Ghaly is the secretary of the California Health and Human Services Agency; he works with partners across sectors and disciplines to improve the lives and life chances of all Californians.

The Payroll and Benefit Services Unit (PBSU) provides services to the over 3,900 CDPH employees throughout California with payroll, benefits, and leave accounting issues and is responsible for ensuring the appropriate application of laws, rules, and bargaining unit contracts related to salaries and wages, health, ...

Tomás Aragón serves as the director of the California Department of Public Health and the State Public Health Officer, since January 4, 2021.

It was formerly known as the California Department of Health Services, which was reorganized in 2007 into the DHCS and the California Department of Public Health.

The California Department of Public Health (CDPH) Center for Health Care Quality (CHCQ) works to ensure that all Californians receive safe, effective, and quality health care, and it does so through regulatory oversight of licensed health care facilities, providers, and certain types of health care professionals.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Cdph8554
Get form
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Form Packages
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
Form Categories
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
Customer Service
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
Legal Guides
  • Real Estate Handbook
  • All Guides
Prepared for you
  • Notarize
  • Incorporation services
Our Customers
  • For Consumers
  • For Small Business
  • For Attorneys
Our Sites
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 3720 Flowood Dr, Flowood, Mississippi 39232
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program