DEPARTMENT OF HEALTH SERVICES Division of Public Health F 02188 (04/2018)STATE OF WISCONSIN Page 1 of 3LYME DISEASE CASE WORKSHEET INSTRUCTIONS: Enter responses in WEDSS or fax completed worksheet.
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How to fill out the WI DHS F-02188 online
Filling out the WI DHS F-02188 Lyme Disease Case Worksheet online is an essential step in reporting Lyme disease cases accurately. This guide provides clear and supportive instructions to help you navigate the form effectively.
Follow the steps to complete the form with ease.
- Click the ‘Get Form’ button to access the worksheet and open it for editing.
- Begin with the demographic information section. Enter the patient's name, date of birth, sex, and contact telephone number. Provide the street address, city, and zip code, along with the patient's race and ethnicity selections.
- In the signs and symptoms history section, indicate whether a physician diagnosed the patient with Lyme disease. Enter the onset date of symptoms and the date of diagnosis.
- Proceed to the clinical/supplemental information section. Record the name of the reporting agency, hospitalization details, and medication prescribed for Lyme disease.
- Complete the diagnostic information by checking the applicable laboratory tests performed, including EIA/IFA and Western Blot.
- Finally, review the exposure history for any recent outdoor activities that may have led to tick exposure. Provide details on the geographical locations and type of exposure.
Complete your Lyme disease case reporting online today.
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Get answers to your most pressing questions about US Legal Forms API.
Can Lyme disease spread from person to person?
There is no evidence that Lyme disease is transmitted from person-to-person through touching, kissing, or having sex with a person who has Lyme disease. Untreated Lyme disease during pregnancy can lead to infection of the placenta. Spread from mother to fetus is possible, but rare.
What is limes disease?
Lyme disease is a bacterial infection spread to humans by infected ticks. It's also known as Lyme borreliosis. Ticks are tiny spider-like creatures found in woodland and moorland areas. They feed on the blood of birds and mammals, including humans. Lyme disease is usually easier to treat the earlier it's diagnosed.
What is the quality of healthcare in Wisconsin?
Wisconsin is Ranked: 4th Largest Share of Five-Star Hospitals in the Country | Wisconsin hospitals' have the fourth-most five-star rated hospitals in the country, ing to the 2023 Overall Hospital Quality Star Ratings from the Centers for Medicare & Medicaid Services (CMS). Read more.
What does the Wisconsin Department of Health Services do?
DHS is committed to protecting and promoting the health and safety of the people of Wisconsin, making sure everyone can live their best life. DHS oversees Medicaid, the single largest program in the state budget, and other health and social service programs.
What are the health priorities in Wisconsin?
The five Priority Areas that were raised as the most important to address to promote individual, community, and population health are: Social and community conditions, including. ... Physical, mental, and systemic safety. Person and community-centered health care. Social connectedness and belonging.
Who regulates hospitals in Wisconsin?
Hospitals: Rules and Regulations | Wisconsin Department of Health Services.
What does Wisconsin DHS do?
DHS is committed to protecting and promoting the health and safety of the people of Wisconsin, making sure everyone can live their best life. DHS oversees Medicaid, the single largest program in the state budget, and other health and social service programs.
Is Lyme disease a reportable disease?
Lyme disease has been a nationally notifiable condition in the United States since 1991. Reports of Lyme disease are collected and verified by state and local health departments in ance with their legal mandate and surveillance practices.
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