State Form 51467 Notification of Blood or Body Fluid Exposure - Indiana

What Is State Form 51467?

This is a legal form that was released by the Indiana State Department of Health - a government authority operating within Indiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 51467?
A: Form 51467 is a notification form for reporting blood or body fluid exposure incidents in Indiana.

Q: Who needs to complete Form 51467?
A: Healthcare professionals and others who are exposed to blood or body fluids in the course of their work in Indiana need to complete Form 51467.

Q: What is the purpose of Form 51467?
A: The purpose of Form 51467 is to document and report incidents of blood or body fluid exposure, so that appropriate follow-up measures can be taken to protect the exposed individuals.

Q: How do I obtain Form 51467?
A: You can obtain Form 51467 from the Indiana State Department of Health or from your employer.

Q: What information is required on Form 51467?
A: Form 51467 requires information about the exposed individual, the source of the exposure, the circumstances of the exposure, and any symptoms or medical treatment that follow.

Q: When should Form 51467 be completed?
A: Form 51467 should be completed as soon as possible after a blood or body fluid exposure incident occurs, ideally within 24 hours.

Q: What happens after I submit Form 51467?
A: After you submit Form 51467, appropriate follow-up measures will be taken, such as medical evaluation, testing, and counseling, to ensure your health and well-being.

Q: Are there any penalties for not completing Form 51467?
A: While there are no specific penalties for not completing Form 51467, it is important to report blood or body fluid exposures to protect your health and the health of others.

Q: Is there a fee for submitting Form 51467?
A: There is no fee for submitting Form 51467. It is a standard notification form provided by the Indiana State Department of Health.