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Form HEA7192 Influenza-Associated Hospitalization Confidential Case Report - Ohio
What Is Form HEA7192?
This is a legal form that was released by the Ohio Department of Health - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the purpose of Form HEA7192?A: The purpose of Form HEA7192 is to report confidential case information related to influenza-associated hospitalizations in Ohio.
Q: Who is required to complete Form HEA7192?A: Healthcare providers and facilities in Ohio are required to complete Form HEA7192 for each influenza-associated hospitalization case.
Q: What information is included in Form HEA7192?A: Form HEA7192 includes information about the patient's demographics, influenza vaccination status, clinical symptoms, laboratory testing, and hospitalization details.
Q: Why is the information on Form HEA7192 confidential?A: The information on Form HEA7192 is confidential to protect the privacy of the patients and comply with applicable laws and regulations.
Form Details:
- Released on May 1, 2018;
- The latest edition provided by the Ohio Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form HEA7192 by clicking the link below or browse more documents and templates provided by the Ohio Department of Health.
Download Form HEA7192 Influenza-Associated Hospitalization Confidential Case Report - Ohio
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