Get Nnnnotification Formotification Formotification Form Kkm - Www2 Moh Gov

The NNNNOTIFICATION FORM KKM is an essential document used for reporting cases of MERS-CoV. Filling out this form accurately is crucial for effective disease surveillance and response. This guide provides clear, step-by-step instructions to assist users in completing the form online, ensuring all necessary information is accurately submitted.

Follow the steps to complete the NNNNOTIFICATION FORM KKM online.

1. Click ‘Get Form’ button to obtain the NNNNOTIFICATION FORM KKM and open it in the editor.
2. Begin filling out the Reporting Centre section by entering the name of the hospital or clinic, phone number, state, and fax number as needed.
3. In the Information of Patient section, provide the patient's details including email, name, age, address, home phone, ethnicity, nationality, occupation, and passport number. Record the date of symptom onset and any symptoms observed.
4. In the Signs and Symptoms section, check all symptoms that apply and document the temperature on admission.
5. Complete the Clinical status at time of report by indicating whether the patient was hospitalized, gender, ward information, and treatment details if applicable.
6. In the Exposure History, indicate if the patient had close contact with a confirmed MERS-CoV patient and if they traveled to affected areas prior to symptom onset.
7. In the Travel History section, list any countries or states visited, duration of stay, and transportation details.
8. Fill in the Diagnostic Evaluation and Reporting Officer sections, including signature, designation, and contact information.
9. For District Health Office use, complete the Contact Tracing and Active Case Finding sections, answering questions related to tracing and examination.
10. Review all information for accuracy and completeness before saving changes. You may then choose to download, print, or share the form as required.

Complete your NNNNOTIFICATION FORM KKM online today for timely disease surveillance and reporting.