Get Cholera And Other Vibrio Illness Surveillance Report - Colorado.gov

This guide provides essential information on how to accurately complete the Cholera And Other Vibrio Illness Surveillance Report. It is designed to assist users in efficiently filling out the form while ensuring all necessary details are included.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to access the Cholera And Other Vibrio Illness Surveillance Report and open it.
2. Begin filling out the first section, Demographic and Isolate Information. Enter the first three letters of the patient's last name, followed by the state, city, and county/parish from which the report is being filed.
3. Provide the patient’s date of birth, age, sex, and ethnicity. Ensure to select the appropriate options clearly indicated on the form.
4. In the Race section, select the option that best fits the patient’s race and indicate the occupation of the patient.
5. Next, check the Vibrio species that were isolated from the patient. Provide the date the specimen was collected and the source of the specimen.
6. If applicable, answer questions regarding the identification confirmation of the Vibrio species at the State Public Health Laboratory. Additionally, complete questions regarding the clinical information such as date and time of onset, symptoms, and any sequelae.
7. Follow through the Epidemiologic Information section, answering questions on potential outbreak scenarios, travel history, and seafood consumption prior to illness.
8. Complete the Seafood Investigation Section if required, providing details on the type of seafood consumed and its source.
9. Once all sections are filled out completely and accurately, review the form for any omissions or errors.
10. Finally, save your changes, and choose to download, print, or share the completed form as needed.

Ensure you complete and submit your Cholera And Other Vibrio Illness Surveillance Report online today.