Reportable Diseases and Events are declared to be communicable and/or dangerous to the public and are to be 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Disease/Event Code in the designated field. This code is essential for identifying the specific disease or event being reported.
3. Fill in the Patient Name, ensuring accuracy as this information is critical for tracking cases.
4. Select the patient's gender and ethnicity from the provided options. This demographic information helps in understanding disease patterns.
5. Complete the address fields, including Street Address, City, State, County, and Zip Code. Accurate location data is vital for public health responses.
6. Input the Date of Birth and Onset Date. These dates are crucial for determining the timeline of illness.
7. Indicate whether the patient was hospitalized, died, or pregnant by selecting 'Yes', 'No', or 'Unknown' as applicable.
8. Provide details about clinical information such as Physician Name, Facility/Hospital Name, and contact numbers for follow-up.
9. Finally, review all entered information for accuracy before submitting your report through our platform.

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