Get Nj Cds-14 2017-2026

The NJ CDS-14 is an important form used for Lyme disease case investigation. Completing this form accurately is crucial for proper documentation and follow-up. This guide provides step-by-step instructions to help you fill out the form online.

Follow the steps to effectively complete the NJ CDS-14 form online.

1. Click the ‘Get Form’ button to access the NJ CDS-14 form and open it in your browser.
2. Start by entering the patient information. Fill in the patient's name, birth date, phone number, and address. Make sure to provide accurate contact details.
3. Select the race and ethnicity of the patient by checking the appropriate boxes. This is important for demographic data collection.
4. In the clinical information section, indicate if the clinician has diagnosed the patient with Lyme disease. If applicable, enter the date of diagnosis. You can mark 'Yes' or 'No' accordingly.
5. Record the symptom onset date. If the exact onset date is unknown, provide the date when symptoms developed that is greater than 30 days before specimen collection.
6. Check any relevant signs or symptoms associated with Lyme disease in the provided categories (rash, musculoskeletal, neurologic, cardiac). Include any additional signs or symptoms not explained by another etiology.
7. Fill in the risk factors section. Indicate whether there was exposure to tick-infested areas, include the date of exposure if applicable, and note if there was a recent tick bite.
8. In the treatment section, provide information on any antibiotics prescribed, including dosage and duration, as well as treatment dates.
9. If the patient was not treated, check the box marked 'NOT TREATED.'
10. Include any additional comments relevant to the patient's case.
11. After completing all fields, review the form for accuracy. Save any changes made to the document.
12. Once finalized, you can download, print, or share the completed form as necessary.

Complete your NJ CDS-14 form online today for accurate documentation.