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Get Mn Covid-19 Case Report Form 2020-2026
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How to fill out the MN COVID-19 Case Report Form online
This guide provides a clear and supportive process for users to complete the MN COVID-19 Case Report Form online. By following these steps, you can ensure accurate reporting for laboratory-confirmed COVID-19 cases.
Follow the steps to successfully complete the form.
- Press the ‘Get Form’ button to access the form and open it in the designated editor.
- Begin with the reporter information section. Enter today's date, the name of your hospital or clinic, your name as the clinician, and your phone number. Additionally, provide the name and contact number of the disease reporter.
- Fill out the COVID-19 testing information. Include the lab name, specimen collection date, and specify the test type used. Indicate the results for PCR/molecular tests and antigen tests, marking whether they were positive, negative, or not done.
- Complete the patient information section. Enter the first and last name of the patient, address, phone number, city, zip code, county, and state. Additionally, provide the patient's date of birth, age, race, and ethnicity.
- Indicate whether the patient works in a healthcare facility or a congregate setting. If applicable, fill in the facility name and the patient's occupation. Also indicate if the patient lives in a congregate setting or attends school/childcare, providing additional details where necessary.
- In the clinical information section, record the date of symptom onset. Determine if the patient was hospitalized, if they were admitted to an ICU, and provide the relevant admission and discharge dates, along with the hospital name. Note if the patient was asymptomatic, pregnant, or deceased, and include the date of death if applicable.
- Once you have filled out all relevant sections, review each entry for accuracy. Finally, you can save changes, download, print, or share the completed form as needed.
Take action now by completing the MN COVID-19 Case Report Form online.
Related links form
After a positive COVID test, it is essential to take at least five days off work if you have symptoms or test positive. You should only return if you are feeling better and following the guidelines from health authorities. The MN COVID-19 Case Report Form supports you in keeping track of your health status during this period.