Follow up Templates

This document is used for following up on the child care susceptible list in Washington.

This document is for tracking and following up on individuals on a school susceptible list in Washington state.

This document is used for reporting cases of Burkholderia infection in the state of Washington.

This form is used for individual follow-up health insurance verification for employers in Wisconsin.

This form is used for reporting follow-up information on active tuberculosis (TB) disease cases in Wisconsin.

This form is used for follow-up notification regarding tuberculosis (TB) from another jurisdiction in Wisconsin. It helps facilitate the coordination of healthcare and tracking of TB cases across jurisdictions.

This document is a survey used to measure how satisfied patients are with their orthotic treatment. The survey helps gather feedback and improve the quality of care provided to patients using orthotics.

This checklist is used for patients suspected or confirmed to have a viral infection. It helps healthcare professionals monitor symptoms, track treatment progress, and ensure proper care.

This document is designed for healthcare professionals to monitor and record the progress of patients undergoing treatment with immunosuppressive drugs, including changes in medication, symptoms, and patient responses.

This document is a follow-up sheet used for screening purposes in Quebec, Canada. It is used to gather additional information or conduct further evaluations after an initial screening process.