Get Dceed Registry A3

Completing the Dceed Registry A3 is essential for accurate reporting of sexually transmitted infections. This guide provides clear steps to help users smoothly navigate through the online form filling process.

Follow the steps to effectively complete the Dceed Registry A3 form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the personal information section by providing your last name, first name, middle initial, and contact details such as street address, city, ZIP code, county, state, and phone number.
3. Enter your date of birth, age, and sex. Provide demographic information, selecting the appropriate racial or ethnic category.
4. Document the lab performing the test, along with their phone number, and the facility or clinic of the provider for proper identification.
5. Record the specimen date and the source of the specimen collected (e.g., vaginal, urine, urethra).
6. Check all applicable boxes for positive test results, including syphilis, gonorrhea, chlamydia, and specify whether you are pregnant.
7. Complete the treatment section, indicating treatments administered for each diagnosed condition, and fill out the date treated and any relevant follow-up information.
8. Review all your entered information to ensure accuracy before finalizing your submission.
9. Once all fields are accurately filled, save changes, and choose to download, print, or share the completed form as needed.

Start filling out the Dceed Registry A3 form online today for a seamless submission experience.