U.S. Department of Health and Human Services - Centers for Disease Control and Prevention Forms

This document is used for tracking and recording an individual's blood pressure readings over a period of time. It assists in monitoring any fluctuations and helps doctors make informed decisions about an individual's health management.

This document provides detailed guidelines on how to accurately measure Orthostatic Blood Pressure, a method used to detect low blood pressure. It's especially helpful for healthcare professionals and patients dealing with hypotension.

This document is used for recording blood pressure measurements while changing positions from lying down to standing up.

This document is a comprehensive tool utilized to keep detailed track of a woman's menstrual cycle, symptoms and severity. It assists in identifying patterns, health issues and is often used in context of fertility planning or diagnosis of menstrual disorders.

This document provides essential information about the vaccines recommended during pregnancy to safeguard both mother and child from various diseases. It includes details on the timing and safety of each vaccine.

This document serves as a reference for healthcare professionals, offering guidance on prescribing opioids for chronic pain management. It aids in assessing patient needs, evaluating their risk of substance misuse, and ensuring ongoing monitoring for safety.

This form is used for tracking the medication intake of Rifampin over a period of 4 months. It is specifically for treating latent tuberculosis infection.

This document provides information on the early warning signs of Autism Spectrum Disorder. It is a valuable resource for parents and caregivers to help identify potential signs of autism in children.

This document provides guidelines and procedures for safely returning a student to school following a concussion. It serves as critical communication between the school, healthcare providers, and parents to ensure a smooth transition and support for the student's health and academic needs.

This form is used for filling out a backpack emergency card to provide important information in case of an emergency.

This document outlines the protocols for administering influenza vaccinations. It provides guidelines for healthcare providers to follow in order to ensure the efficient and effective distribution of flu shots.

This document provides a summary of influenza vaccination rates among healthcare personnel. It highlights the percentage of healthcare workers who have received the flu vaccine.

This document provides the CDC's recommended immunization schedule for adults aged 19 years or older. It outlines the vaccines that adults should receive to protect against vaccine-preventable diseases.

This document outlines the recommended immunization schedule for premature babies. It provides guidance on when and which vaccines should be given to protect these infants from various diseases.

This document is used for keeping track of your personal medicines. It includes the names and dosages of all the medications you take.

This form is utilized for recording and monitoring the temperature of the Pfizer-Biontech Covid-19 vaccine in ultra-cold storage facilities, with readings in Celsius, thereby ensuring its efficacy during distribution and storage.

This form is used to record the temperature log for storing Covid-19 vaccines in a refrigerator. It is specifically designed for tracking the temperature of the vaccines stored in Celsius for the first 15 days.

This form is used for reporting whether you have been sick from a virus or bacteria.

This document provides guidelines for vaccinations and immunizations to ensure health safety of children between ages 10 and 18 who are behind on their vaccination schedules. It outlines the necessary vaccines and their recommended doses based on age and previous vaccination history.

This form is used for meticulously tracking and recording temperatures when vaccines are being transported under refrigerated conditions. It ensures the maintenance of optimal temperature during transit, safeguarding vaccine effectiveness.

This form is used for tracking and recording the temperature of refrigerated Covid-19 vaccines. It provides a systematic way to ensure the vaccines are stored at an optimal temperature within the first 15 days.

This document is for outlining the terms and conditions between a healthcare provider and patient, regarding the use of prescription pain medication. It helps to manage risks and ensure safe, effective treatment.

This form provides guidelines for immunization catch-up schedules for children aged 4 months to 17 years within the USA, offering detailed vaccine recommendations and timelines.

This form is used by legal guardians in Oklahoma to give consent for their child under 18 or adult conservatee to receive the Covid-19 vaccine. It outlines necessary information and guidelines surrounding vaccine administration.

This document is used to conduct an annual survey on patient safety in hospitals. It is an important tool for gathering information and improving patient care.

This form is specifically designed for monitoring the storage and expiration dates of the Pfizer-Biontech Covid-19 vaccine. It helps ensure correct storage conditions and timely use, thus maximizing vaccine efficacy and safety.

This document serves as a comprehensive list of supplies needed for setting up temporary vaccination clinics in satellite or off-site locations, ensuring efficient vaccination processes without any supply shortages. It assists in planning and meeting the equipment needs for mass vaccination campaigns.