Get Arbovirus Case Investigation Bformb - Departamento De Salud De Bb

Filling out the Arbovirus Case Investigation Bformb is crucial for accurately reporting arboviral infections. This guide provides step-by-step instructions to assist you in completing the form online with clarity and confidence.

Follow the steps to complete the Arbovirus Case Investigation Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter today's date by filling in the day, month, and year as required in the header of the form.
3. In the 'Check suspected arboviral infection' section, mark all infections that apply, including dengue, Zika, chikungunya, or any other infection.
4. Complete Section 1 with the patient's data. Indicate if the patient was hospitalized, the hospital name, and the medical record number. Provide the full name of the patient and, if applicable, the name of the primary caregiver.
5. Fill in the patient's home address in Section 2. Ensure to include all relevant details like street name, building, and ZIP code. Provide a reference point near the patient's residence.
6. In Section 3, record the patient's demographic information. Include their date of birth, age, sex, and pregnancy status if applicable.
7. Section 4 requires you to provide details regarding the patient's symptoms and the date of specimen collection. Specify dates and types of samples taken.
8. Complete Section 5 with the physician's contact information. Ensure to include all necessary details since results will only be sent to this provider.
9. In Section 6, write the name of the individual who filled out the form and their relationship with the patient, along with their contact information.
10. Fill out Section 7 by noting the patient's country of birth and any travel history prior to the onset of symptoms.
11. In Section 8, check the boxes that indicate the patient's signs and symptoms, specifying the platelet count and answering all related questions.
12. Finally, after reviewing all sections, save your changes, and you may choose to download, print, or share the form as needed.

Complete your documents online confidently and ensure timely reporting.