Get Measles Investigation Form - Department Of Health And Social ...

Filling out the Measles Investigation Form is a crucial step in reporting potential cases of measles and ensuring public health safety. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately and effectively online.

Follow the steps to complete the Measles Investigation Form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name of the individual at the top of the form. Ensure the name is spelled correctly as it is essential for identification purposes.
3. Next, fill in the date of birth by specifying the year, month, and day. This information helps determine the age of the person, which is relevant for medical evaluation.
4. Indicate the community affiliation. This could help with identifying demographics for public health planning.
5. Select the gender of the individual, marking either 'Male' or 'Female'.
6. Choose the ethnicity from the provided options, such as Dene, Inuit, Métis, or Other. This is important for accurate reporting and health resource allocation.
7. Document the history of illness, including the onset date, duration, and any concurrent illnesses. This gives healthcare providers a comprehensive view of the individual's health status.
8. Record any underlying illnesses that the individual may have, as this can impact treatment and responses to immunization.
9. Fill in the immunization history, noting the date, product lot number, and dosage. If no immunization occurred, specify the reason.
10. Indicate whether the individual was hospitalized and provide the name of the hospital if applicable.
11. Under laboratory investigation, mark the type of tests conducted, such as culture or serology, and enter the dates and results.
12. If applicable, record recent activities, including travel locations, dates, and group meetings attended.
13. Document the living conditions by specifying the number of people living in the house and the number of rooms, which can be important for health assessments.
14. List any complications or sequelae of the illness if present and necessary.
15. Provide contact information by listing the person reporting the case, their title, and place of employment.
16. Finally, review all the information entered. Once everything is accurate, you can save your changes, download the form, or print it for submission.

Complete your Measles Investigation Form online to help ensure public health safety.