Get Ca Notification From Medical Provider Of Covid-19 Laboratory Results - County Of Los Angeles 2021-2025

This guide provides clear and supportive instructions for completing the CA Notification From Medical Provider Of COVID-19 Laboratory Results form for individuals reporting COVID-19 laboratory results in Los Angeles County. By following these steps, users will be able to fill out the form accurately and efficiently online.

Follow the steps to complete the form online easily.

1. Press the ‘Get Form’ button to access the form electronically and open it for editing.
2. Fill in the medical provider information section, including the physician or infection preventionist's name, facility name, pager or phone number, email address, and date of report.
3. Complete the patient information section by providing the patient's full name, date of birth, gender identity, sex at birth, age, and sexual orientation. Select the options that apply to the patient from the provided choices.
4. Indicate the patient's race or ethnicity by checking all applicable boxes and provide the patient's address, city, state, ZIP code, primary and alternative phone numbers, and email address.
5. Specify the patient's current residence type from the available options, such as private residence or healthcare worker.
6. Move to the clinical information section and indicate if the patient is symptomatic. If yes, state the date of symptom onset and include the medical record number and any pre-existing medical conditions by checking the relevant boxes.
7. In the laboratory information section, fill out details about the specimen type, the type of test performed, and the collection date. Record whether the result was positive, and if applicable, include information about COVID-19 vaccinations.
8. Once all sections are completed, review the form for accuracy and completeness, ensuring all required fields have been filled. Save any changes made to the form.
9. Finally, users can download, print, or share the form as needed, and ensure to submit it according to the instructions provided.

Complete your documents online today for efficient processing.