Communicable Disease Report Form for Healthcare Providers

Form Template

Healthcare providers are required to report selected infectious diseases to the local health department for disease control and prevention.

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The Communicable Disease Report Form for Healthcare Providers app is a vital tool for thoroughly reporting a case of an infectious disease. The healthcare provider will indicate the diagnosis or suspected infection, the illness onset date, and diagnosis date and then report the risk and outcome information. The app is used to organize any lab results with the specimen type and date collected. The form includes individuals sections for case reporting sexually transmitted diseases, HIV/AIDS, Hepatitis and Tuberculosis. Contact information for local health departments is included. This app is essential for communicable disease prevention.

Features
  • Signature Capture
  • GPS
  • Image Capture
  • Conditional Fields
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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