Infectious Disease Templates

This form is used for reporting cases of malaria in Washington state. It helps the Department of Health track and monitor the spread of the disease in order to take appropriate public health measures.

This form is used for reporting cases of mumps in the state of Washington.

This form is used for reporting cases of plague in Washington state.

This form is used for reporting cases of shigellosis, a contagious bacterial infection, in Washington state.

This form is used for reporting Varicella (chickenpox) related deaths in the state of Washington.

This form is used for reporting cases of yellow fever in Washington.

This form is used for reporting cases of Yersiniosis in the state of Washington.

This Form is used for assessing the Covid-19 status of patients being transferred from a hospital to a post-acute care facility in Texas.

This form is used for reporting cases of reportable diseases in West Virginia. It helps health authorities track and monitor the spread of infectious diseases.

This form is used for collecting and documenting patient information for possible human rabies cases.

This form is used for investigating cases of yersiniosis in Ohio.

This Form is used for reporting cases of Tickborne Rickettsial Disease.

This Form is used for reporting cases of Coccidioidomycosis (Valley Fever) in Ohio. It is part of an enhanced surveillance program to track and monitor the spread of this fungal infection.

This form is used for reporting cases of Q Fever, a bacterial infection that can cause flu-like symptoms and is transmitted to humans from animals.

This form is used for reporting cases of leptospirosis, a bacterial infection spread through contact with contaminated water.

This form is used for reporting confidential information about communicable diseases in the state of Indiana.

This document is used for recording the vaccination history of individuals for Hepatitis A in the state of New Hampshire.

This form is used for reporting notifiable diseases in Washington, D.C. It helps in tracking and monitoring infectious diseases to protect public health.

This form is used for submitting samples of potentially rabid animals for testing in New Brunswick, Canada. It is important to follow the instructions provided to ensure the proper collection and submission of the sample. This is essential for the prevention and control of rabies in the province.

This form is used for reporting positive Covid-19 test results in the state of Tennessee.

This document is proof that an animal has received a vaccination against rabies. It is often required for traveling with pets or enrolling them in certain facilities.

This document provides the guidelines for administering higher doses of the Hepatitis B vaccine as per the health regulations of British Columbia, Canada. It includes a detailed schedule for vaccination and other relevant information.

This document provides comprehensive guidelines on vaccination and tuberculosis screening protocol for individuals working in child care centers, as enacted by the City of Toronto, Ontario, Canada. It's meant to ensure safety and health of both employees and children.

This document is used to provide specific details about the seasonal influenza vaccine and secures consent from individuals in Taiwan to receive the vaccination. It contains information on the vaccine's purpose, potential risks, and benefits.

This tool is designed to aid Canadian residents in conducting a self-assessment for potential Covid-19 symptoms, helping to reduce the spread of the virus and manage the healthcare system's load.

This document is utilized by businesses to monitor the health status of employees amidst the pandemic. It outlines a set of screening questions regarding Covid-19 symptoms and exposure to maintain workplace safety.

This document outlines the recommended immunization schedule for children in the United States. It provides information on the vaccines that children should receive and when they should receive them to protect against various diseases.

This document provides a guide for conducting health screenings in workplaces in Michigan to prevent the spread of Covid-19. It includes best practices, protocols, and the necessary measures to implement.

This form is used for investigating cases of invasive Group A Streptococcus disease in Indiana.

This form is used for reporting cases of Candida Auris in the state of Indiana.