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2013 WA DOH 347-102 - Thurston County

2013 WA DOH 347-102 - Thurston County-2025

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The document is a confidential sexually transmitted disease (STD) case report form intended for use by Thurston County Public Health. It includes sections for patient information, diagnosis, treatment options, and partner management plans for various STDs such as gonorrhea, chlamydia, and syphilis. The form emphasizes the importance of reporting STDs within three workdays and provides guidelines for partner treatment and management. Additionally, it outlines recommended antimicrobial regimens for treating these infections and offers resources for obtaining free medications for partners.

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Click ‘Get Form’ to open the 2013 WA DOH 347-102 in our 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, sex, and ethnicity. Ensure all fields are completed accurately.
In the 'Diagnosis – Disease' section, select the appropriate diagnosis by checking only one box for Gonorrhea, Syphilis, Chlamydia Trachomatis, or Herpes Simplex. Fill in any additional details as required.
Complete the 'Partner Management Plan' by selecting a method for ensuring partner treatment. Indicate how many partners will be treated and provide necessary details.
Finally, fill out the 'Reporting Clinic Information' section with facility name, address, diagnosing clinician's name, and contact information before saving your changes.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (83 Votes)
2016	4.2 Satisfied (67 Votes)
2013	4.4 Satisfied (127 Votes)

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What does the Washington state Department of health do?

DOH provides comprehensive public health services and programs to the community through a workforce of approximately 2,000 public health professionals all dedicated to improving the health and well-being of Washingtonians and the communities in which they live, learn, work, worship, and play.

How do I request records in Thurston County?

The public may request documents for review and copying. Office hours are 8:00 AM to 5:00 PM., Monday through Friday. The public records request form may be submitted to the following e-mail address tcpra@co.thurston.wa.us or mailed to the Assessors Office at 2000 Lakeridge Drive SW, Olympia, WA 98502.