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.
Q: What is the CDPH8263 Pertussis Supplemental Form?
A: The CDPH8263 Pertussis Supplemental Form is a form used for cases of pertussis (whooping cough) in infants who are 4 months of age or younger in California.
Q: Who is required to complete this form?
A: Healthcare providers who diagnose pertussis in infants who are 4 months of age or younger in California are required to complete this form.
Q: What information is included in the form?
A: The form includes information such as patient demographics, symptoms, lab results, immunization history, and treatment details for pertussis cases in infants 4 months of age or younger.
Q: Why is this form important?
A: This form is important for tracking and monitoring cases of pertussis in infants in California and helps in implementing appropriate public health interventions to control the spread of the disease.
Q: Are there any penalties for not completing the form?
A: Failure to complete and submit the CDPH8263 Pertussis Supplemental Form for cases of pertussis in infants who are 4 months of age or younger in California may result in administrative penalties or legal consequences for healthcare providers.
Form Details:
Download a fillable version of Form CDPH8263 by clicking the link below or browse more documents and templates provided by the California Department of Public Health.