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  • Cdc Form 57 205

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HCW Name, Last: Exposure Event #: First: Middle: *Date of Birth: / / *Gender: F M Other *Work Location: *Occupation: If occupation is physician, indicate clinical specialty: Section I General Exposure Information 1. *Did exposure occur in this facility: Y N 1a. If No, specify name of facility in.

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How to fill out the Cdc Form 57 205 online

Filling out the Cdc Form 57 205 is an essential process for documenting exposures to blood or body fluids in healthcare settings. This guide provides step-by-step instructions to assist users in completing the form accurately and efficiently online.

Follow the steps to successfully complete the form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Enter your facility ID number in the provided field at the top of the form.
  3. Provide your healthcare worker ID number and full name, including last, first, and middle name.
  4. Fill in the required date of birth and select your gender from the given options.
  5. List your work location and occupation, specifying any clinical specialty if applicable.
  6. Answer the general exposure questions in Section I, starting with whether the exposure occurred in the facility.
  7. Indicate the date and time of exposure, along with the number of hours you were on duty.
  8. Confirm if you are a temp or agency employee and specify the location of the exposure.
  9. Select all applicable types of exposure and indicate the fluid or tissue involved.
  10. Document the body site of exposure by checking all that apply.
  11. Complete subsequent sections based on the nature of your exposure, ensuring all required fields are thoroughly addressed.
  12. Once all sections are completed, review your form for any errors or omissions.
  13. Save your changes, and then you can choose to download, print, or share the completed form as needed.

Start completing your Cdc Form 57 205 online today.

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