Get Fo-13323-004 Formulario De Notificacin Zoonticas - Msp Gub

The FO-13323-004 Formulario De Notificacin Zoonticas is crucial for notifying health authorities of suspected zoonotic diseases. This guide provides a clear and comprehensive approach to filling out this form online, ensuring that all necessary information is correctly submitted.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the form and open it in your editing tool.
2. In the section labeled 'Caso sospechoso de ENFERMEDAD ZOONOTICA', select the specific event you are reporting. Choices include Hantavirosis, Leptospirosis, Brucelosis, Fiebre Q, or Carbunco. Ensure you mark all that apply.
3. Enter the date of notification in the format ___/___/_____.
4. Record the date symptoms began and the date of consultation. If the person was hospitalized, indicate the institution and the date of admission.
5. For 'Datos del caso', fill in the identified individual’s identification number (CI), name in printed letters, gender, date of birth, age, neighborhood, and address details. Include contact information like telephone or mobile number.
6. In the 'Datos del notificador', provide your name and specify your role as the notifier, along with your contact number.
7. Navigate to the 'INFORMACION COMPLEMENTARIA' section and indicate any clinical and epidemiological data, such as fever, headaches, muscular pain, or other symptoms. Note the relevant dates of symptom onset where applicable.
8. Complete additional questions regarding recent activities or exposures, marking 'Yes' or 'No' as appropriate.
9. Input any laboratory results and specify the type of tests conducted, along with their results in the designated areas.
10. Conclude by providing the final diagnosis, classification of the case, and your initials. Also, remember to update the date at the bottom of the form.
11. Finally, review your entries for accuracy and completeness. You can then save your changes, download, print, or share the form as needed.

Complete your notification forms online today to ensure timely health reporting.