New Hampshire Lyme Disease Case Report Form - Health Care Provider - New Hampshire

New Hampshire Lyme Disease Case Report Form - Health Care Provider - New Hampshire

New Hampshire Lyme Disease Case Report Form - Health Care Provider is a legal document that was released by the New Hampshire Department of Health and Human Services - a government authority operating within New Hampshire.

FAQ

Q: What is the purpose of the Lyme Disease Case Report Form?A: The Lyme Disease Case Report Form is used by health care providers in New Hampshire to report cases of Lyme disease.

Q: Who is required to complete the Lyme Disease Case Report Form?A: Health care providers in New Hampshire are required to complete the Lyme Disease Case Report Form for all confirmed and probable cases of Lyme disease.

Q: What information is required on the Lyme Disease Case Report Form?A: The Lyme Disease Case Report Form requires information such as the patient's demographics, clinical information, and laboratory test results.

Q: Is reporting Lyme disease cases mandatory in New Hampshire?A: Yes, health care providers in New Hampshire are required to report all confirmed and probable cases of Lyme disease using the Lyme Disease Case Report Form.

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Form Details:

  • Released on March 1, 2014;
  • The latest edition currently provided by the New Hampshire Department of Health and Human Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Health and Human Services.

Download New Hampshire Lyme Disease Case Report Form - Health Care Provider - New Hampshire

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