Get Report Of Verified Case Of Tuberculosis - California Department Of ... - Cdph Ca

The Report Of Verified Case Of Tuberculosis is an essential document used for the surveillance and reporting of tuberculosis cases in California. This guide will provide clear, step-by-step instructions on how to complete the form online, ensuring that your submission is accurate and timely.

Follow the steps to complete the form online effectively.

1. Press the ‘Get Form’ button to access the Report Of Verified Case Of Tuberculosis form and view it in your preferred online document editor.
2. Begin by entering the patient’s name in the appropriate fields, ensuring you include their last name, first name, and middle initial.
3. Fill in the street address of the patient comprehensively, including the number, street, city, state, and ZIP code.
4. Complete the case completion report section by entering the year counted and the case number as assigned by your health department.
5. Indicate whether the sputum culture conversion has been documented by selecting 'Yes', 'No', or 'Unknown'. If 'No', specify the reason for not documenting it.
6. If sputum culture conversion was documented, enter the date on which the first consistently negative sputum culture specimen was collected.
7. Address whether the patient moved during therapy and, if so, provide the relevant details about their new location.
8. Enter the dates related to therapy received or stopped, providing detailed explanations in the fields provided regarding any issues that led to changes in therapy.
9. In the final section of the form, provide comments as necessary and ensure all sections are thoroughly checked for accuracy.
10. Once all fields are completed and reviewed, save your changes. You may download or print the form for your records and submit it as required.

Take the first step and complete your Report Of Verified Case Of Tuberculosis online today.