Get Reporting Sexually Transmitted Disease Form Florida

Filling out the Reporting Sexually Transmitted Disease Form in Florida is a crucial step in ensuring proper documentation and management of sexually transmitted diseases. This guide will provide you with clear and supportive instructions to navigate the form effectively online.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to access the Reporting Sexually Transmitted Disease Form and open it in your selected editor.
2. Begin by indicating the patient's gender and pregnancy status. Select the appropriate checkboxes for Female, Male, Not Pregnant, or Pregnant, and provide the pregnancy due date if applicable.
3. In the section for chlamydia, check the relevant types that apply to the patient, such as ophthalmia or pelvic inflammatory disease.
4. Proceed to the gonorrhea section and mark the applicable strains as necessary, including options like disseminated gonococcal or uncomplicated.
5. For syphilis, enter the RPR titer and select the types of confirmatory tests that were positive for the patient.
6. Describe any other sexually transmitted diseases present by checking the relevant boxes and indicating any specifics as requested.
7. Fill in the collection dates for the tests performed and identify the reporting laboratory for each corresponding test.
8. Document the treatment dates, selecting from the recommended regimens provided in the treatment section, and specifying dosage as needed.
9. If the patient is pregnant, indicate the recommended treatment options that apply.
10. Complete the form by filling out the healthcare professional’s information including name, practice name, address, and phone number.
11. Once all fields are completed, review the information for accuracy. Save your changes, and then print or download the form as needed for submission.
12. Finally, fax the completed form to the appropriate number provided in the document.

Start filling out the Reporting Sexually Transmitted Disease Form online today to ensure accurate reporting and support.