Home
Forms Library
Confidential reportable disease case report

West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv 2026

confidential reportable disease case report Preview on Page 1

See details

4.6 out of 5

38 votes

The document is a confidential report form from the West Virginia Bureau for Public Health used for reporting cases of reportable diseases. It includes sections for patient information, disease details, laboratory tests, and reporting requirements categorized by urgency. The document outlines legal obligations for healthcare providers to report various communicable diseases within specified timeframes to local or state health departments.

Here's how it works

01. Edit your confidential reportable disease case report online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv with DocHub

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering the Disease Name at the top of the form. This is crucial for accurate reporting.
Fill in the Patient’s Name, Date of Birth, and Guardian/Parent’s Name. Ensure all names are printed clearly.
Complete the address fields including City, State, and Zip Code. This information helps local health departments reach you if necessary.
Indicate whether the patient was hospitalized and provide details if applicable. This section is important for tracking disease spread.
Document laboratory tests, dates, and results in the designated area. Attach copies as needed for thoroughness.
Finally, review all entries for accuracy before signing and dating the form at the bottom. Keeping a copy for your records is recommended.

Start using our platform today to streamline your document editing and ensure accurate submissions!

See more West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv versions

We've got more versions of the West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv form. Select the right West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2011	4.6 Satisfied (38 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is considered a reportable disease?

A disease that, when diagnosed, requires health providers (usually by law) to report to state or local public health officials. Notifiable diseases are of public interest by reason of their contagiousness, severity, or frequency.

Which of these should be reportable diseases to public health?

Reportable Diseases DiseaseWhen to Report Rabies, human Immediately Rubella (including congenital) 1 day Salmonellosis (Salmonella) 3 days Severe acute respiratory syndrome (SARS) Immediately51 more rows

What diseases have to be reported to the health department?

Diseases reportable to the CDC include: Anthrax. Arboviral diseases (diseases caused by viruses spread by mosquitoes, sandflies, ticks, etc.) such as West Nile virus, eastern and western equine encephalitis. Babesiosis. Botulism. Brucellosis. Campylobacteriosis. Cancer. Candida auris, clinical.

What illnesses should be reported?

Diseases you must report Notifiable diseaseWhether likely to be routine or urgent Smallpox Urgent Tetanus Routine. Urgent if associated with injecting drug use Tuberculosis Routine. Urgent if healthcare worker, or suspected cluster or multi-drug resistant Typhus Routine30 more rows Sep 12, 2024

Which of the following are notifiable diseases?

Details of Notifiable Diseases Source Of Infection And Prevention Dengue Fever Diptheria Hepatitis-A Hepatitis-B Influenza Leprosy Malaria Measles Cerebro Spinal Fever Whooping Cough (Pertusis) Plague Polio5 more rows

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

What are reportable specified diseases?

Reportable occupational diseases Diagnosis by a doctor. A reportable disease must be diagnosed by a doctor. If you are self-employed. Reportable diseases. Carpal tunnel syndrome. Cramp of the hand or forearm. Occupational dermatitis. Hand-arm vibration syndrome. Occupational asthma.

Which infectious diseases must be reported?

Diseases you must report Notifiable diseaseWhether likely to be routine or urgent Enteric fever (typhoid or paratyphoid fever) Urgent Food poisoning Routine. Urgent if part of a cluster or outbreak Haemolytic uraemic syndrome (HUS) Urgent Infectious bloody diarrhoea Urgent30 more rows Sep 12, 2024

What disease is mandatory to report?

Mandatory written reporting: A report of the disease must be made in writing. Examples are gonorrhea and salmonellosis. Mandatory reporting by telephone: The provider must make a report by phone. Examples are rubeola (measles) and pertussis (whooping cough).

West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv 2026

Here's how it works

How to use or fill out West Virginia Reportable Infectious Diseases Health Care - DHHR - dhhr wv with DocHub