Fax Page 1 To:Adapted from WA DOH Form 347102Thurston County Public HealthAttn. Phuong Nguyen, (833) 4181916 (Confidential FAX line)CONFIDENTIAL SEXUALLY TRANSMITTED DISEASE CASE REPORT Report STDs.

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How to fill out the WA DOH 347-102 - Thurston County online

Filling out the WA DOH 347-102 form online is essential for reporting sexually transmitted diseases accurately and efficiently. This guide provides step-by-step instructions to help you complete the form with confidence.

Follow the steps to fill out the WA DOH 347-102 form online.

  1. Click the ‘Get Form’ button to download the WA DOH 347-102 form and open it in an online editor.
  2. Begin with the patient information section. Fill in the last name, first name, middle name, date of birth, address, city, state, zip code, and phone number.
  3. Indicate whether the patient is currently pregnant by selecting Yes, No, or Unknown. Also, check if the patient is an English speaker.
  4. Select the reason for the examination by checking one of the provided categories (e.g., exposed to infection, symptomatic). Include any additional relevant details.
  5. In the sections for different STDs, provide the date tested and check the appropriate diagnosis options according to the lab results.
  6. Fill out the partner treatment plan, noting any prescribed medications and treatment options, while ensuring to record the dates as well.
  7. Complete the reporting clinic information section by entering your facility's name, address, and the person completing the form. Don't forget to include contact information.
  8. Once all sections are filled out accurately, save changes, and you will have the option to download, print, or share the completed form as needed.

Take the first step towards effective health reporting by completing the WA DOH 347-102 form online today.

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Thurston County Public Health Adapted from WA DOH...

Thurston County Public Health. Attn. Phuong Nguyen, (833) 418-1916 (Confidential FAX...

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