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Positive flu test results pdf

Positive flu test paperwork 2026

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The document is a reporting worksheet for positive rapid influenza test results, intended for weekly submission to regional health departments. It specifies that only positive rapid antigen tests should be reported, while other types of tests must be submitted electronically. The worksheet must be faxed by noon on Monday for the preceding week and emphasizes that influenza is reportable year-round.

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Click ‘Get Form’ to open the Positive Rapid Influenza Test Results Reporting Worksheet in the editor.
Begin by entering the reporting week dates in the format __/__/__ - __/__/__ (Sunday – Saturday) at the top of the form.
Fill in your Reporting Facility/Practice and County information in the designated fields.
In the 'Total Positive Rapid Tests by Type' section, record the number of positive tests for each type (A, B, A or B, Unknown) for each day of the week.
Ensure that you only report positive rapid antigen detection tests using this worksheet. Other types of tests should be reported electronically as specified.
Once completed, fax this worksheet by NOON on MONDAY to your regional health department. If you prefer email submission, contact them for instructions.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (34 Votes)
2014	4.7 Satisfied (47 Votes)

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