DOH Form 420-214 Tickborne Diseases Reporting Form (Excludes Lyme, Relapsing) - Washington

DOH Form 420-214 Tickborne Diseases Reporting Form (Excludes Lyme, Relapsing) - Washington

What Is DOH Form 420-214?

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.

FAQ

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.

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Form Details:

  • Released on November 1, 2019;
  • The latest edition provided by the Washington State Department of 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 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.

Download DOH Form 420-214 Tickborne Diseases Reporting Form (Excludes Lyme, Relapsing) - Washington

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