Get Az Dhs Communicable Disease Outbreak Report

The AZ DHS Communicable Disease Outbreak Report is a critical tool for reporting communicable disease outbreaks to appropriate health agencies. This guide provides clear and supportive instructions on how to fill out the report online, ensuring accuracy and compliance with reporting requirements.

Follow the steps to successfully complete the report online.

1. Click ‘Get Form’ button to obtain the document and open it in your preferred online editor.
2. In the section titled 'Information known about the suspected outbreak', provide the following details: - Diagnosis (known or suspected) - Date and time when the outbreak was detected - Date and time when symptoms began - Source of the outbreak (known or suspected) - Number of cases (known or suspected) - Total number of individuals in the facility, including staff - Description of signs and symptoms - Specific information about areas affected, including classrooms or grades, units, or areas as applicable, along with the number of areas affected and their names.
3. Complete the 'Outbreak location information' section by entering the following: - Name of the outbreak location (e.g., name of school or facility) - Type of setting, indicating the appropriate option (e.g., Assisted Living, Child Care Facility, etc.) - Full street address, including city, state, zip code, and county - Name and contact information for the person making this report.
4. In the 'Notes/Comments' section, include any additional relevant information regarding the outbreak or special circumstances that need to be noted.
5. After completing the form, review all entries for accuracy, then you can choose to save changes, download, print, or share the form as needed.

Take the next step to ensure public health safety by completing the AZ DHS Communicable Disease Outbreak Report online.