Get Hepatitis D Case Report Form. A Case Report Form On Hepatitis D For Public Health Units.

This guide provides clear instructions for completing the Hepatitis D Case Report Form online. By following the steps outlined, users will ensure accurate and comprehensive reporting essential for public health tracking and response.

Follow the steps to successfully complete the Hepatitis D Case Report Form.

1. Click ‘Get Form’ button to access the Hepatitis D Case Report Form and open it for editing.
2. Begin filling out the case name section. Enter the name of the case and the reporter's first name and surname along with the date of birth. Ensure all personal information is accurate for effective identification.
3. Input the notification ID and public health unit information. This section is crucial for tracking and interdepartmental communication.
4. Document the outbreak ID, the name of the person completing the form, and the date the form was sent to the relevant authorities.
5. Complete the notification details. Input the dates of notification and the initial response from public health. Indicate the notifier's name and their organization, including their contact information.
6. Fill in the case details section. Provide the person’s name, date of birth, sex, and ethnicity. Include their permanent and temporary addresses, along with contact numbers.
7. Enter clinical details, including the date of onset of symptoms, any complications, and hospitalization status. Specify if the case has chronic infection or is pregnant.
8. Complete the laboratory section by providing information about previous hepatitis B testing and any relevant serology or PCR results.
9. Fill out the hepatitis B vaccination details. Document the date and type of each vaccination received.
10. In the exposure period section, specify any potential risks and relevant dates. This can include anything from drug use to healthcare exposure.
11. Provide details regarding the place of acquisition and the notification decision. This helps categorize the case accurately.
12. Finally, review all entered information thoroughly for any errors or omissions before saving changes, downloading, printing, or sharing the completed form.

Complete your Hepatitis D Case Report Form online now to contribute to public health efforts.