DOH Form 420-031 Outbreak Reporting Form - Influenza-like Illness - Washington

DOH Form 420-031 Outbreak Reporting Form - Influenza-like Illness - Washington

What Is DOH Form 420-031?

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 DOH Form 420-031?
A: DOH Form 420-031 is the Outbreak Reporting Form for Influenza-like Illness in Washington.

Q: What is this form used for?
A: This form is used to report outbreaks of influenza-like illness in Washington.

Q: Who is required to fill out this form?
A: Healthcare facilities and providers are required to fill out this form.

Q: What is considered an outbreak?
A: An outbreak is defined as an increase in the number of cases of influenza-like illness above the expected level for a given time and place.

Q: What information is required on the form?
A: The form requires information about the facility, dates of the outbreak, number of cases, symptoms, and control measures taken.

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Form Details:

  • Released on October 1, 2020;
  • 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 420-031 by clicking the link below or browse more documents and templates provided by the Washington State Department of Health.

Download DOH Form 420-031 Outbreak Reporting Form - Influenza-like Illness - Washington

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