Get Leptospirosis Special Investigation Form - Field Version 2008 12 22doc - Epid Gov

Completing the Leptospirosis Special Investigation Form is a critical task for public health inspectors and medical officers of health. This guide provides clear, step-by-step instructions to assist users in accurately filling out the form online, ensuring that necessary information is collected effectively.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill out the 'Case Notification' section by providing the week ending date of notification, ensuring the format is correct.
3. In the 'Present Illness/Outcome' section, indicate the date of onset of symptoms. Specify where the patient first sought medical advice by checking one of the provided options.
4. Provide details about hospital admission including the name of the hospital, ward, BHT No., and outcome of the case, ensuring to fill out the relevant checkboxes for items applicable.
5. In the 'Clinical Data' section, review patient notes if available and check the symptoms and complications experienced by the patient that align with the case definition.
6. Proceed to the 'Laboratory Diagnosis' section and answer questions regarding laboratory tests conducted. Specify if blood was taken for serology, including specimen details and laboratory results.
7. Address questions about the patient's family or associates who experienced similar illness, and detail any prophylactic treatment taken by the patient.
8. Finally, include any remarks, affix your signature, name, date, and designation in the designated area.

Complete your documents online to ensure effective and timely health responses.