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Form CDPH9064 Provider Report Form - California Gonorrhea Surveillance System - California
What Is Form CDPH9064?
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 CDPH9064 form?
A: The CDPH9064 form is the Provider Report Form for the California Gonorrhea Surveillance System in California.
Q: What is the purpose of the CDPH9064 form?
A: The purpose of the CDPH9064 form is to collect information about gonorrhea cases from healthcare providers in California.
Q: Who uses the CDPH9064 form?
A: The CDPH9064 form is used by healthcare providers in California.
Q: What information is collected on the CDPH9064 form?
A: The CDPH9064 form collects information about gonorrhea cases, including patient demographics, symptoms, treatment, and testing information.
Q: How is the CDPH9064 form used?
A: The information collected on the CDPH9064 form is used for surveillance and monitoring of gonorrhea cases in California, as well as for public health interventions and prevention efforts.
Form Details:
- Released on November 17, 2014;
- 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 CDPH9064 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.
Download Form CDPH9064 Provider Report Form - California Gonorrhea Surveillance System - California
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