Get Skagit County Confidential Sexually Transmitted Disease Case Report And Fax Prescription For Std

This guide provides clear and supportive instructions for filling out the Skagit County Confidential Sexually Transmitted Disease Case Report And Fax Prescription For STD online. Each section of the form is explained to ensure accurate and timely reporting.

Follow the steps to complete your case report accurately.

1. Press the ‘Get Form’ button to access the form and open it in your document management system.
2. Fill in the patient information section. Include the last name, first name, middle initial, address, telephone number, city/town, state, ZIP code, and date of diagnosis. Ensure that all fields are completed accurately.
3. Indicate the patient's ethnicity and race by checking the appropriate boxes. This is important for demographic reporting purposes.
4. Select the reason for the examination by checking one of the options: symptomatic, routine exam, or exposed to infection.
5. Provide details about the patient's gender, date of birth, and the gender(s) of their sexual partners. Ensure that this information is precise to facilitate proper management of the case.
6. Document the diagnosed diseases by selecting the applicable option under the diagnosis section. Specify the site(s) if relevant.
7. List the treatments prescribed using the relevant checkboxes. Provide dates for when tests were conducted and treatments were prescribed to ensure all records are current.
8. Complete the partner management plan. Indicate the selected method for ensuring the treatment of all partners, and specify how many partners will be treated.
9. Fill in the reporting clinic information, including the date, diagnosing clinician's name, facility name, and contact information.
10. Review the completed form for accuracy and clarity. Once verified, you can save changes, download, print, or share the form as needed.

Start filling out the Skagit County Confidential Sexually Transmitted Disease Case Report And Fax Prescription For STD online today!