This is a legal form that was released by the South Carolina Department of Health and Human Services - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DHHS Form 3400E?
A: DHHS Form 3400E is an application addendum specifically for tuberculosis (TB) referral in South Carolina.
Q: What is tuberculosis (TB)?
A: Tuberculosis (TB) is an infectious disease caused by bacteria that primarily affects the lungs.
Q: What is the purpose of the Tuberculosis (TB) Referral?
A: The purpose of the Tuberculosis (TB) Referral is to assist in the identification and referral of individuals who may have tuberculosis (TB) and need further evaluation and treatment.
Q: Who should use DHHS Form 3400E?
A: DHHS Form 3400E should be used by individuals or healthcare providers in South Carolina who suspect or are referring someone for tuberculosis (TB) evaluation.
Q: What information is required on DHHS Form 3400E?
A: DHHS Form 3400E requires information such as the patient's demographics, medical history, symptoms, and contact information.
Q: Is DHHS Form 3400E specific to South Carolina?
A: Yes, DHHS Form 3400E is specifically for tuberculosis (TB) referral in South Carolina and may not be applicable in other states.
Q: What should I do if I suspect someone has tuberculosis (TB) in South Carolina?
A: If you suspect someone has tuberculosis (TB) in South Carolina, you should complete DHHS Form 3400E and refer them for evaluation and treatment through the appropriate channels, such as contacting the local DHEC office.
Form Details:
Download a fillable version of DHHS Form 3400E by clicking the link below or browse more documents and templates provided by the South Carolina Department of Health and Human Services.