Get Tx Dshs Hepatitis B Acute Case Track Record 2018-2026

Filling out the TX DSHS Hepatitis B Acute Case Track Record is a crucial step in managing and tracking hepatitis B cases. This guide will walk you through each section of the form in a clear and supportive manner, ensuring you complete it accurately and efficiently.

Follow the steps to complete the Hepatitis B Acute Case Track Record effectively.

1. Use the ‘Get Form’ button to access the TX DSHS Hepatitis B Acute Case Track Record and open it in your preferred editor.
2. Begin by entering the NBS PATIENT ID# at the top of the form, followed by the FINAL STATUS. Indicate whether the case is confirmed as acute or chronic, or ruled out.
3. Fill in the patient's name in the designated sections, providing both last and first names. Then, note the agency that reported the case and their contact information.
4. Record the patient's address, phone number, city, county, and zip code in the respective fields. Ensure the date reported is also accurately noted.
5. Indicate the region and the phone number of the individual or agency that investigated the case in the provided fields.
6. If applicable, fill in the parent or guardian's details along with their agency information.
7. Enter the physician's name and contact details, including their address and email.
8. Document the investigation start date and mark the checkbox if the patient has a history of homelessness in the last six months.
9. Input the date the investigation was completed.
10. In the demographics section, indicate the patient's sex, date of birth, race, and whether the patient is Hispanic.
11. If the patient is female, denote if they are currently pregnant and provide the obstetrician's information.
12. Complete the clinical data, including whether the patient was hospitalized and the reason for testing.
13. Provide laboratory testing details, including the diagnosis date, lab test date, and results for HBsAg, total anti-HBc, and IgM anti-HBc.
14. Record liver enzyme levels and vaccination history, detailing any vaccinations received, the year of the last shot, and antibody test results.
15. Answer questions about the patient's contact with confirmed hepatitis cases and any relevant history concerning tattoos, drug use, and healthcare exposure.
16. Fill out the incarceration details if applicable.
17. Complete the non-sexual household and sexual contacts requiring prophylaxis by providing names, relations, ages, and vaccine information.
18. Check all applicable control measures related to notifications and vaccinations and add any comments.
19. Finally, review all entries for accuracy, then save changes, and download or print the completed form for your records.

Start filling out your TX DSHS Hepatitis B Acute Case Track Record online today!