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Benton franklin health district wa" Keyword Found Websites ... 2026

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  1. Click ‘Get Form’ to open the Confidential Sexually Transmitted Disease Case Report in the editor.
  2. Begin by filling out the 'Patient Information' section. Enter the patient's last name, first name, address, city, state, zip code, date of birth, sex, ethnicity, and race. Ensure all fields are completed accurately.
  3. In the 'Diagnosis - Disease' section, select only one disease from Gonorrhea, Syphilis, Chlamydia Trachomatis, or Herpes Simplex. For each selected disease, indicate the site(s) affected and any relevant treatment prescribed.
  4. Complete the 'Partner Management Plan' by selecting a method for ensuring partner treatment. Indicate how many partners will be treated and provide necessary details.
  5. Finally, fill out the 'Reporting Clinic Information' section with your facility name, address, diagnosing clinician's name, and contact information before submitting.

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