This is a legal form that was released by the Washington State Department of Health - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is the purpose of Form 420-214?
A: Form 420-214 is a Tickborne Diseases Reporting Form for Washington state, excluding Lyme and relapsing fever.
Q: Who is required to complete Form 420-214?
A: Healthcare providers are required to complete Form 420-214 for cases of tickborne diseases in Washington state, excluding Lyme and relapsing fever.
Q: What tickborne diseases are included in Form 420-214?
A: Form 420-214 includes tickborne diseases other than Lyme and relapsing fever.
Q: What information is required in Form 420-214?
A: Form 420-214 requires information about the healthcare provider, patient, and the tickborne disease case.
Form Details:
Download a printable version of DOH Form 420-214 by clicking the link below or browse more documents and templates provided by the Washington State Department of Health.