Get Tx Eepi-2 2017-2025

The TX EEPI-2 form is essential for reporting suspected cases of notifiable conditions in Texas. This guide will help you understand each component of the form and provide step-by-step instructions for filling it out online.

Follow the steps to successfully complete the TX EEPI-2 form online.

1. Click ‘Get Form’ button to access the TX EEPI-2 form and open it in your preferred format.
2. In the 'Disease or Condition' section, select the appropriate type by checking either 'Onset' or 'Absence'. Indicate the date of onset or the closest known date.
3. Fill in the practitioner’s name, including the office visit or specimen collection type if applicable. Include the practitioner’s phone number and, if necessary, the facility's contact information.
4. Provide the patient's details, including their name (last, first, middle initial), address (street, city, state, zip code), date of birth, age, and phone number.
5. Select the patient's sex by checking either 'Male' or 'Female'. Fill out the ethnicity and race options as applicable.
6. In the 'Notes' section, include any additional information such as lab tests, clinical information, pregnancy status, occupation (if relevant), school name/grade, or travel history.
7. Fill in the name and address of the reporting facility, along with the name and title of the person reporting. Include the date of the report, email, and phone number with extension.
8. For health department use, indicate whether the case is confirmed, probable, suspected, dropped, or a duplicate with new information.
9. Review all entered information for accuracy. Once confirmed, save your changes, and consider downloading, printing, or sharing the completed form.

Complete and submit your TX EEPI-2 form online today for efficient reporting.