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2016 form 347 102 benton frankliny confidential transmitted disease

2016 form 347 102 benton frankliny confidential transmitted disease-2026

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The document is a confidential sexually transmitted disease (STD) case report form intended for use by healthcare providers to report STDs to the Benton-Franklin Health District. It includes sections for patient information, diagnosis details, treatment regimens, and partner management plans. The document emphasizes the importance of timely reporting and partner treatment, providing guidelines for managing gonorrhea, chlamydia, and syphilis cases. Additionally, it outlines procedures for obtaining free medications for partners and encourages collaboration with the health department for effective partner notification.

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Click ‘Get Form’ to open the 2016 form 347 102 in the editor.
Begin by filling out the 'Patient Information' section. Enter the patient's last name, first name, address, city, state, zip code, date of birth, and contact information.
Next, complete the 'Diagnosis - Disease' section. Select only one disease from options like Gonorrhea or Chlamydia and indicate if it is lab confirmed.
In the 'Treatment' section, check all prescribed treatments for the diagnosed disease. Ensure to include dates for each prescription given.
Fill out the 'Partner Management Plan' by selecting a method for ensuring partner treatment and indicating how many partners will be treated.
Finally, complete the 'Reporting Clinic Information' section with details about the diagnosing clinician and facility before submitting your form.

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Versions	Form popularity	Fillable & printable
2019	4.9 Satisfied (45 Votes)
2016	4.8 Satisfied (207 Votes)
2012	4 Satisfied (32 Votes)

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Which sexually transmitted infection must be reported to the local health department?

The Disease Control and Epidemiology unit monitors the rates of reportable sexually transmitted diseases (STDs). These include gonorrhea, chlamydia and syphilis. In addition, Hepatitis B, AIDS, and other reportable infections that are sexually transmissible are counted.

What STD has to be reported?

Case data are available for nationally notifiable STDs, including chancroid, chlamydia, gonorrhea, and syphilis.

Are STD records public?

When a health care provider diagnoses a patient with a reportable disease, he or she must notify certain agencies of the occurrence of a new case of this disease. The reporting process is confidential and allows health workers to reduce the spread of STDs. Every state has its own list of reportable diseases.

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Can you look up to see if someone has an STD?

Confidential: This is similar to any other medical appointment in that your results will go onto your medical records and you will be able to obtain your records again at any point in the future. Your health insurance may cover this testing.

Do you have to report trichomoniasis to the CDC?

Most infections are asymptomatic. In those with symptoms of disease, or trichomoniasis, the most common symptoms are vaginitis in women and urethritis in men. T. vaginalis infection is not currently reportable in any US state.

Does STD stay on your record?

STI and reports are kept confidential.

Do STDs show up on medical records?

STDs Stay On Medical Records When you get tested for STDs at a doctors office and use insurance, the results are reported to your insurance company. The insurance company then has those results placed on your medical record. Some insurances will even raise your insurance rates if you test positive for STDs.

2016 form 347 102 benton frankliny confidential transmitted disease-2026

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Got questions?

Can I complete and sign my 2016 form 347 102 benton frankliny confidential transmitted disease online?

How do you get 2016 form 347 102 benton frankliny confidential transmitted disease for my state?

Which sexually transmitted infection must be reported to the local health department?

What STD has to be reported?

Are STD records public?

Security and compliance

Complete this form in 5 minutes or less

People also ask

Can you look up to see if someone has an STD?

Do you have to report trichomoniasis to the CDC?

Does STD stay on your record?

Do STDs show up on medical records?

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