Get Rheumatic Heart Disease (rhd) Case Report Form. Rheumatic Heart Disease (rhd) Case Report Form

Filling out the Rheumatic Heart Disease (RHD) Case Report Form accurately is essential for reporting confirmed and borderline cases. This guide provides straightforward, step-by-step instructions to help you complete the form online with confidence.

Follow the steps to complete the Rheumatic Heart Disease Case Report Form.

1. Click the ‘Get Form’ button to access the Rheumatic Heart Disease Case Report Form and view it in your preferred editor.
2. Enter the patient's hospital or clinic identification number in the designated field.
3. Provide the patient's family name and given name in the respective fields.
4. Indicate the notification date by entering the day, month, and year.
5. For the notifying clinician, fill in their name, telephone number, address, and practice or department details.
6. Next, enter the name of the parent or carer, along with their contact information.
7. Include details of the general practitioner or usual healthcare provider, which also requires sex identification and practice name.
8. Mark the indigenous status of the patient, specifying if they identify as Aboriginal, Torres Strait Islander, both, or neither.
9. Indicate the country of birth and ethnic background, providing options as applicable.
10. Document any history of previous acute rheumatic fever (ARF) and the year it occurred, if applicable.
11. In the clinical details section, specify the echocardiogram date and service provider along with the severity classification of RHD.
12. Include the earliest date of RHD diagnosis along with the location of the initial diagnosis.
13. Ensure to attach the latest echocardiogram and specialist reports with the submission of the form.
14. Once all fields are completed, you can save changes, download the form, print it for your records, or share it as needed.

Complete your Rheumatic Heart Disease Case Report Form online today to ensure accurate reporting.