Get the free infectious disease notification form

INFECTIOUS DISEASES ACT CHAPTER 137 MD 131 Regulation 3 NOTIFICATION OF INFECTIOUS DISEASES UNDER SECTION 6 PARTICULARS OF PATIENT Please appropriate box where applicable NRIC No./Passport No./Foreign Identification Number FIN Name of Patient BLOCK LETTERS Date of Birth dd/mm/yyyy Gender Ethnic Group Residential Status Male Chinese Indian Resident Female Malay Others Non-Resident Occupation Residential Address Postal Code Place of Work/School/Child Care Centre/Kindergarten Telephone No. Home...

How to fill out infectious disease notification form

How to fill out an infectious disease notification form:

1. Obtain the form: Contact the relevant local health department or visit their website to access the infectious disease notification form.
2. Provide personal information: Fill in your personal details such as your full name, address, phone number, and email address. This information is crucial for contact tracing purposes.
3. Specify the disease: Indicate the infectious disease you are reporting. Include any relevant details such as the name of the disease, date of diagnosis, and symptoms experienced.
4. List potential contacts: Provide information about individuals who may have come into contact with the infected person. Include their names, contact information, and the dates and locations of encounters.
5. Attach supporting documentation: If available, attach any medical reports, test results, or laboratory documentation related to the diagnosed disease.
6. Submit the form: Send the completed infectious disease notification form to the designated health department either via mail, email, or through their online submission portal.

Who needs infectious disease notification form:

1. Healthcare professionals: Doctors, nurses, and other healthcare workers who diagnose an infectious disease in a patient are typically required to complete the notification form.
2. Laboratories: Medical laboratories that identify infectious diseases through diagnostic tests often need to submit notification forms to the local health department.
3. General public: In certain situations, individuals who have been diagnosed with certain infectious diseases may also be required to fill out this form to help with contact tracing efforts and prevent further spread of the disease. It is advisable to check with the local health department for specific guidelines regarding individual notification requirements.

People Also Ask about

What is the process of disease notification?

Disease notification is the collection of reports of cases of illness required by law, which include information on symptoms, on demographic characteristics, and key risk factors.

What is the CDC mandatory reporting of infectious diseases?

Mandatory written reporting: A report of the disease must be made in writing. Examples are gonorrhea and salmonellosis. Mandatory reporting by telephone: The provider must make a report by phone. Examples are rubeola (measles) and pertussis (whooping cough).

What infectious diseases need to be reported?

Healthcare Provider Reportable Diseases Anthrax, human or animal. Botulism (Infant, Foodborne, Wound, Other) Brucellosis, human. Cholera. Ciguatera Fish Poisoning. Dengue Virus Infection. Diphtheria. Domoic Acid Poisoning (Amnesic Shellfish Poisoning)

What is the disease notification process?

Disease notification is a practice of reporting the occurrence of a specific disease or health-related condition to the appropriate and designated authority. 2. A notifiable disease is any disease that is required by law to be reported to government authorities.

What is the purpose of disease notification?

Notification is a vital step in efforts to prevent or control the spread of infection and to prevent further harmful exposures. Notification is required by law and penalties exist for failing to notify. The law exists to protect the public's health and safety.

What are 3 notifiable infectious diseases?

Nationally Notifiable Diseases Cholera. Cryptosporidiosis. Cyclosporiasis. Giardiasis. Hepatitis A. Legionellosis. Malaria* Salmonellosis.

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What is infectious disease notification form?

An infectious disease notification form is a document used by healthcare providers to report cases of infectious diseases to public health authorities.

Who is required to file infectious disease notification form?

Healthcare providers, such as doctors, nurses, and laboratories, are typically required to file infectious disease notification forms when they identify cases of reportable infectious diseases.

How to fill out infectious disease notification form?

To fill out the form, providers must gather patient information, including demographics, clinical details, and specific disease information, and then submit it to the relevant public health agency according to local regulations.

What is the purpose of infectious disease notification form?

The purpose of the infectious disease notification form is to enable public health authorities to track the incidence of infectious diseases, identify outbreaks, and implement control measures to protect public health.

What information must be reported on infectious disease notification form?

The information typically required includes patient demographics (name, age, sex), clinical information (diagnosis, symptoms), date of diagnosis, and any relevant travel or exposure history.