Get Avian Influenza Case Report Form

Completing the Avian Influenza Case Report Form online is essential for timely reporting and management of potential cases. This guide will provide you with a step-by-step approach to accurately fill out the form, ensuring that all necessary information is captured efficiently.

Follow the steps to complete the form correctly.

1. Use the ‘Get Form’ button to access the Avian Influenza Case Report Form. This will open the document in an editable format ready for completion.
2. Begin by filling out the notification section. Include basic details such as the notification ID, the date of initial response, and contact information for both the notifier and the treating doctor.
3. In the case details section, provide the individual's name, date of birth, sex, and contact details. Be sure to include any relevant information about the individual's ethnicity and language preferences.
4. Fill out the clinical details section, indicating the onset of symptoms, any significant medical history, and current health status. Include information about any antiviral treatments and relevant chronic conditions.
5. Specify the case status. Indicate whether the case is under investigation, suspected, probable, or confirmed based on the available evidence.
6. Detail the exposure period by providing information on any known contact with cases of avian influenza, direct contact with poultry, and travel history.
7. Provide vaccination details, if applicable, regarding prior influenza and pneumococcal vaccinations.
8. Complete the contact management section, listing contacts and the recommended interventions for each person in contact with the case.
9. Finally, review all information for accuracy. Once completed, you can save your changes, download a copy, print it, or share it as needed.

Take the next step in public health by filling out the Avian Influenza Case Report Form online today.