Get Cdc Sample Short Data Collection Form. Cdc Sample Short Data Collection Form - Bt Cdc

Filling out the CDC Sample Short Data Collection Form is a crucial step in various public health investigations. This guide provides user-friendly, step-by-step instructions to ensure that you accurately complete the form online, facilitating efficient data collection and reporting.

Follow the steps to effectively complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in an online editor.
2. Fill in today’s date in the format month/day/year.
3. Enter the location of the outbreak including the state and city.
4. Select the sex of the patient and enter their age in years and months.
5. If hospitalized, provide the facility name, city, county, and state, along with the phone number and medical record number.
6. Fill in the patient's present address, including facility name, street, city, county, and state if applicable.
7. Document the date of first presentation for medical care and the date of symptom onset.
8. Complete the exposure history section by describing any known illnesses in relationships to the patient, exposure to animals or insect bites, and travel history.
9. Use the general notes/comments section for any additional relevant information.
10. Fill out the clinical data section according to the health parameters listed for the individual.
11. Indicate treatment details, including hospital admission, ICU admission, and any interventions like supplemental oxygen or mechanical ventilation.
12. Document any laboratory testing performed, detailing specimens collected and tests requested.
13. Complete the laboratory results section, specifying the results of the testing conducted.
14. If a radiological test was performed, indicate whether it was a chest X-ray or chest CT scan and detail the results.
15. Once all fields are completed, save changes, and consider options to download, print, or share the form as necessary.

Ensure accurate and timely reporting by completing the CDC Sample Short Data Collection Form online.