State Form 51467 Notification of Blood or Body Fluid Exposure - Indiana

State Form 51467 Notification of Blood or Body Fluid Exposure - Indiana

What Is State Form 51467?

This is a legal form that was released by the Indiana State Department of Health - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 51467?
A: Form 51467 is a notification form for reporting blood or body fluid exposure incidents in Indiana.

Q: Who needs to complete Form 51467?
A: Healthcare professionals and others who are exposed to blood or body fluids in the course of their work in Indiana need to complete Form 51467.

Q: What is the purpose of Form 51467?
A: The purpose of Form 51467 is to document and report incidents of blood or body fluid exposure, so that appropriate follow-up measures can be taken to protect the exposed individuals.

Q: How do I obtain Form 51467?
A: You can obtain Form 51467 from the Indiana State Department of Health or from your employer.

Q: What information is required on Form 51467?
A: Form 51467 requires information about the exposed individual, the source of the exposure, the circumstances of the exposure, and any symptoms or medical treatment that follow.

Q: When should Form 51467 be completed?
A: Form 51467 should be completed as soon as possible after a blood or body fluid exposure incident occurs, ideally within 24 hours.

Q: What happens after I submit Form 51467?
A: After you submit Form 51467, appropriate follow-up measures will be taken, such as medical evaluation, testing, and counseling, to ensure your health and well-being.

Q: Are there any penalties for not completing Form 51467?
A: While there are no specific penalties for not completing Form 51467, it is important to report blood or body fluid exposures to protect your health and the health of others.

Q: Is there a fee for submitting Form 51467?
A: There is no fee for submitting Form 51467. It is a standard notification form provided by the Indiana State Department of Health.

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Form Details:

  • Released on November 1, 2011;
  • The latest edition provided by the Indiana State Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of State Form 51467 by clicking the link below or browse more documents and templates provided by the Indiana State Department of Health.

Download State Form 51467 Notification of Blood or Body Fluid Exposure - Indiana

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