
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.
Open form follow the instructions
Easily sign the form with your finger
Send filled & signed form or save
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.
- Click the ‘Get Form’ button to download the WA DOH 347-102 form and open it in an online editor.
- 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.
- Indicate whether the patient is currently pregnant by selecting Yes, No, or Unknown. Also, check if the patient is an English speaker.
- Select the reason for the examination by checking one of the provided categories (e.g., exposed to infection, symptomatic). Include any additional relevant details.
- In the sections for different STDs, provide the date tested and check the appropriate diagnosis options according to the lab results.
- Fill out the partner treatment plan, noting any prescribed medications and treatment options, while ensuring to record the dates as well.
- 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.
- 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.
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Related content
Thurston County Public Health. Attn. Phuong Nguyen, (833) 418-1916 (Confidential FAX...
Get answers to your most pressing questions about US Legal Forms API.
Who regulates hospitals in Washington state?
Washington State hospitals are also regulated by the Department of Health. As such, we seek to share information from the DOH with our member hospitals and health systems to help ensure WSHA members comply with the law and are informed of important deadlines and policy changes.
Who runs the Washington state Department of Health?
Umair A. Shah, MD, MPH, is the Secretary of Health for the great state of Washington, appointed by Governor Jay Inslee in December 2020.
Who is the director of public health in Washington state?
Umair A. Shah, M.D., M.P.H. - Washington State Department of Health | LinkedIn.
What branch of government is the Washington State Department of Health?
Within the executive branch, there are six major departments: Environment and Natural Resources, General Government, Transportation, Health and Human Services, Education, and Community and Economic Development.
How do I contact the Washington state Department of Health?
General Information Call the DOH Information Line at 1-800-525-0127. For faster service, follow the prompts and leave a message with the appropriate program.
Who is the head of the DSHS in Washington state?
Meet Our Leadership Jilma Meneses Secretary of DSHS Lisa Yanagida Chief of Staff Mike Williams Deputy Chief of Staff Terry Redmon Assistant Secretary Economic Services Bea Rector Assistant Secretary Aging and Long-Term Support Kevin Bovenkamp Assistant Secretary Behavioral Health5 more rows
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down process here.