
Case name: ..DOB .......Notification ID: .. Sporadic caseSTEC/HUS Questionnaire Outbreak case Outbreak ref: PRIVACY MESSAGE (if required) The information you provide in this questionnaire is for the.
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How to fill out the AU STEC/HUS Questionnaire online
The AU STEC/HUS Questionnaire is an essential form used to collect vital information to help prevent the further spread of illness. This guide provides clear and supportive instructions for filling out the questionnaire online, enabling users to complete it with confidence.
Follow the steps to successfully complete the AU STEC/HUS Questionnaire online.
- Press the ‘Get Form’ button to access the questionnaire and open it for editing.
- In the first section, provide the case name, date of birth, and notification ID. Choose whether this is a sporadic case or an outbreak case.
- Complete the privacy message section, ensuring that you understand the purpose of the questionnaire and the confidentiality of your information.
- Fill in the case details section, including the public health unit, first name, surname, date of birth, sex, and other requested personal information.
- If applicable, provide the parent's or guardian's name and any relevant contact information, including phone numbers and email.
- Indicate your employment status and any relevant occupation details, particularly if it involves handling food or contact with vulnerable populations.
- In the clinical section, detail the symptoms experienced, the onset date of symptoms, and any medical visits related to the illness.
- Complete the laboratory section, noting any tests conducted and the results.
- Next, provide information about any contacts who experienced similar symptoms within 10 days prior to your illness.
- Move on to travel exposures to document any travel that occurred before illness onset.
- Fill in information about any environmental exposures, including activities like camping, contact with animals, or use of untreated water.
- Document any food purchases made prior to the illness and indicate if you have any special dietary restrictions or allergies.
- Complete the section on eating outside the home within the 10 days leading to illness, detailing establishments and meals consumed.
- Finally, review all the completed sections, save your changes, and choose to print, download, or share the form as needed.
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