F 44243 case 2025

1. Click ‘Get Form’ to open the f 44243 case in the editor.
2. Begin with Section A: Patient Demographic Information. Fill in the patient's last name, first name, middle initial, date of birth, age, sex, and gender. Ensure you include a complete mailing address including apartment number, city, state, county of residence, race, and telephone number.
3. Move to Section B: Disease Classification Related to Diagnosis. Check all applicable boxes for diseases suspected or confirmed based on the patient's condition.
4. In Section C: Laboratory Test(s) Related to Current Diagnosis, report each test type and specimen source on a new line. Include dates for specimen collection and analysis along with test results.
5. Complete Section D: Treatment (RX) Information by checking all relevant treatments provided. Document details such as medication type, dosage, and duration.
6. Finally, ensure that all sections are filled accurately before submitting the form to the Local Health Department within the required timeframe.

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