Get Ca Notification From Medical Provider Of Covid-19 Laboratory Results - County Of Los Angeles 2020-2025

Completing the CA Notification From Medical Provider Of COVID-19 Laboratory Results is an essential process for reporting COVID-19 laboratory results. This guide provides clear instructions on filling out the form online to ensure accurate submission.

Follow the steps to fill out the form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the medical provider information section: Enter the facility name, physician or infection preventionist name, pager or phone number, email address, and the date of the report.
3. Complete the patient information section: Provide the patient's full name (last, first, middle initial), the facility name if applicable, address including number, street, apartment number, city, ZIP code, primary and alternative phone numbers, email address, and occupation.
4. Indicate the patient's current residence: Select from options such as private residence, residential care or assisted living, nursing home, shelter, or other relevant places.
5. Provide clinical information: Fill in the date of onset, whether the patient has been hospitalized, and if hospitalized, the date of admission. Include the medical record number.
6. Check applicable signs and symptoms of the patient: Indicate if the patient has any of the listed symptoms such as fever, cough, sore throat, etc. or specify any other symptoms.
7. List pre-existing medical conditions: Choose any relevant conditions the patient may have, or indicate if there are none.
8. Enter laboratory information: Complete the details regarding nasal pharyngeal swab and oropharyngeal swab, including date of collection, results, and performing lab name.
9. Detail epidemiology risk factors: Indicate if the patient had close contact with a confirmed COVID-19 patient or provide travel history to affected areas along with the dates of travel.
10. Review all entered information for accuracy before finalizing the form.
11. Send the completed form to the Acute Communicable Disease Control Program by fax or secure email, as instructed at the end of the form.

Complete your documents online today for accurate and timely reporting.