Get Salmonellosis Case Investigation Form

Completing the Salmonellosis Case Investigation Form online is an important step in managing and tracking cases of salmonellosis. This guide will provide you with clear, step-by-step instructions to ensure accurate and efficient completion of the form.

Follow the steps to fill out the form accurately.

1. Press the ‘Get Form’ button to access the form and open it in your browser.
2. Begin by entering the patient’s name and CEDRS number in the designated fields. Ensure you have accurate identification information.
3. Fill in the interview date, agency name, and your name as the person completing the form. Specify your relationship to the interviewee by selecting from the options provided.
4. In the demographics and contact information section, record the patient's date of birth, age, race, ethnicity, and sex as required.
5. Enter the patient's contact information, including residence, email, and multiple phone numbers as applicable.
6. Gather and input laboratory information. Confirm whether the case is culture confirmed, lab name, serotype, date specimen collected, and specimen source.
7. Document the clinical description, including symptom onset dates and whether the patient was hospitalized, along with details of their hospitalization.
8. Complete the infection timeline section. Enter the onset date and calculate the exposure and communicable periods as instructed.
9. Fill in travel information, including any travel outside or within the US prior to symptom onset.
10. Provide details about the patient’s water source and any animal exposure, including specific contact with pets.
11. List any relevant restaurant history or group activities during the week leading up to the illness.
12. Complete grocery and food history sections to detail food consumption in the week prior to illness.
13. Answer hygiene and food handling questions to assess any potential risks in the patient's behavior.
14. Provide educational guidance and document any restrictions applied to the case following the investigation results.
15. After filling out the form, review your responses for accuracy. Save your changes, and if necessary, download or share the completed form.

Begin filling out the Salmonellosis Case Investigation Form online today to help track and manage cases effectively.