PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form CDPH9070
for the current year.
Form CDPH9070 Severe Influenza Case History Form (Icu and Fatal Cases) - California
What Is Form CDPH9070?
This is a legal form that was released by the California Department of Public Health - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the CDPH9070 Severe Influenza Case History Form?
A: The CDPH9070 Severe Influenza Case History Form is a document used in California to gather information about severe influenza cases, specifically those that resulted in ICU admission or death.
Q: Who uses the CDPH9070 Severe Influenza Case History Form?
A: The CDPH9070 Severe Influenza Case History Form is used by healthcare professionals and public health officials in California.
Q: What information does the CDPH9070 Severe Influenza Case History Form collect?
A: The CDPH9070 Severe Influenza Case History Form collects information about the patient's demographics, underlying medical conditions, influenza vaccination status, clinical presentation, hospitalization details, and outcomes.
Q: Why is the CDPH9070 Severe Influenza Case History Form important?
A: The CDPH9070 Severe Influenza Case History Form helps public health officials track and monitor severe influenza cases in California, which can help inform public health interventions and prevention strategies.
Form Details:
- Released on September 1, 2018;
- The latest edition provided by the California Department of Public Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CDPH9070 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.
