
V. 3.3 (September 2020)State/NNDSS ID# (Required) Cyclosporiasis National Hypothesis Generating Questionnaire Form Approved OMB No. 09201198 Exp. Date 09/30/2023General information (Questions to be.
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How to use or fill out the HHS CDC Cyclosporiasis National Hypothesis Generating Questionnaire online
Filling out the HHS CDC Cyclosporiasis National Hypothesis Generating Questionnaire is crucial for understanding Cyclosporiasis infections. This guide provides a clear and supportive approach to help users complete the form accurately online.
Follow the steps to accurately complete the questionnaire.
- Press the ‘Get Form’ button to access the questionnaire and launch it in your preferred online format.
- Begin with the General Information section, where the interviewer would classify the case according to CDC definitions. Choose either 'Confirmed' or 'Probable' as required, and complete the accompanying fields for laboratory information including dates of stool collection and test results.
- In the Laboratory Information section, accurately specify the type of testing laboratories and methods used. Select all that apply, such as clinical lab or commercial lab, and indicate any additional information relevant to the lab-confirmed co-infection.
- Continue to the Interviewer Information section, where you must fill in the interviewer’s name, agency or organization, contact phone number, and interview date. Make sure this information is accurate to ensure follow-up, if necessary.
- Next, answer demographic questions about the case-patient, including state, county, zip code, date of birth, age, sex, and ethnicity. Provide as much detail as possible to help with the assessment.
- Proceed to the Clinical Information section and document the symptoms experienced by the case-patient, including the start date of symptoms and whether they were hospitalized.
- In the Travel, Events, and Ill Contacts section, note any travel details and events attended during the 14 days prior to illness onset. Specify locations and dates with as much detail as possible.
- Complete the sections related to sources of produce both at home and outside. List specific stores, restaurants, and any information about food consumed during the period before becoming ill.
- Fill in the sections about fresh herbs, fruits, leafy greens, and other fresh vegetables similarly, ensuring to indicate whether they were consumed at home or away.
- Once all sections are completed, review your answers for accuracy. After verification, you may save your changes, download, print, or share the completed questionnaire as needed.
Complete the HHS CDC Cyclosporiasis National Hypothesis Generating Questionnaire online to contribute to important public health research.
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