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 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.
Form Details:
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.