Get Wa Doh 347-102 - Benton-frankliny 2016-2025

This guide provides a straightforward approach to completing the WA DOH 347-102 - Benton-Frankliny form online. By following these steps, users can ensure proper submission of case reports for sexually transmitted diseases while adhering to confidentiality requirements.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the patient information section. Enter the last name, first name, middle initial, address, city, zip code, state, and email. Ensure that you provide accurate data as this is crucial for effective reporting.
3. Next, fill in the patient's date of birth, gender, race, and ethnicity. Check the appropriate boxes for any questions related to the patient's HIV testing and diagnosis date.
4. Indicate the reasons for the exam by checking the relevant boxes, especially if the patient is pregnant. This section is essential for understanding the context of the report.
5. In the diagnosis section, specify the sexually transmitted disease diagnosed and tick the applicable boxes corresponding to the symptoms and sites tested.
6. Document the treatment prescribed for the patient, ensuring to check all medications supplied and providing the dates of these prescriptions. This helps in tracking compliance and effectiveness.
7. For partner management, select the method of ensuring partner treatment. This is critical for public health management and preventing further transmission of STDs.
8. Complete the reporting clinic section by providing the clinic name, the person completing the form, and their contact details. This information supports the verification process.
9. Review all entered information for accuracy and completeness before finalizing. Errors in reporting can lead to complications in follow-up care.
10. Once satisfied with the entries, users can save changes, download, print, or share the completed form as needed.

Start filling out your WA DOH 347-102 - Benton-Frankliny form online today to ensure timely and accurate reporting.