CAMPYLOBACTERIOSIS CASE INVESTIGATION FORM - colorado 2026

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  1. Click ‘Get Form’ to open the CAMPYLOBACTERIOSIS CASE INVESTIGATION FORM in the editor.
  2. Begin by entering the patient’s name and CEDRS number at the top of the form. Ensure that you also fill in the interview date and agency name.
  3. In the Demographics and Contact Information section, provide details such as date of birth, age, sex, race, ethnicity, and language spoken. This information is crucial for accurate case tracking.
  4. Complete the Laboratory Information section by confirming lab results with the patient. Record whether cultures were positive or negative and include relevant dates.
  5. Proceed to Clinical Description where you will indicate if symptoms were present. Note onset dates for diarrhea, fever, vomiting, etc., ensuring all fields are accurately filled.
  6. Fill out sections regarding exposure history including travel information, water consumption, pet exposure, and restaurant history. This helps identify potential sources of infection.
  7. Finally, review all entries for accuracy before saving your completed form. Utilize our platform's features to easily share or print your document as needed.

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The state requires laboratories and health providers to report when you test positive for HIV, syphilis, chlamydia, or gonorrhea.
Health care providers: Report a single case of diagnosed illness (such as Salmonella or E. coli O157).
Report a disease Hanta (Hantavirus Pulmonary Syndrome) Malaria. Prion Diseases. Plague. Q fever. Rabies. Rabies in Colorado. Animal control and animal care professionals. Public health health care professionals. Veterinarians. Rabies data. Historical rabies data. Tick-borne diseases. Tularemia.
Campylobacteriosis is a nationally notifiable disease in the United States.

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