Establishing secure connection…Loading editor…Preparing document…
Get and Sign Case Form
Testing performed by state local or CDC lab. At this time all confirmatory testing occurs at CDC Report date of PUI to CDC MM/DD/YYYY // Report date of case to CDC MM/DD/YYYY County of residence State of residence Ethnicity Hispanic/Latino Non-Hispanic/ Latino Not specified Unknown Other Date of first positive specimen collection MM/DD/YYYY N/A Did the patient develop pneumonia Yes No respiratory distress syndrome diagnosis/etiology for their illness Was the patient hospitalized If yes...Show details
Handy tips for filling out Case online
Quick steps to complete and eSign Michigan case online:
- Use Get Form or simply click on the template preview to open it in the editor.
- Start completing the fillable fields and carefully type in required information.
- Use the Cross or Check marks in the top toolbar to select your answers in the list boxes.
- Utilize the Circle icon for other Yes/No questions.
- Look through the document several times and make sure that all fields are completed with the correct information.
- Insert the current Date with the corresponding icon.
- Add a legally-binding eSignature. Go to Sign -> Add New Signature and select the option you prefer: type, draw, or upload an image of your handwritten signature and place it where you need it.
- Finish filling out the form with the Done button.
- Download your copy, save it to the cloud, print it, or share it right from the editor.
- Check the Help section and contact our Support team if you run into any issues when using the editor.
We know how stressing completing documents can be. Gain access to a HIPAA and GDPR compliant service for optimum straightforwardness. Use signNow to eSign and share Information For Health Departments On Reporting A Person for eSigning.
be ready to get more
Create this form in 5 minutes or less
Create this form in 5 minutes!
How to create an eSignature for the information for health departments on reporting a person
The way to generate an electronic signature for a PDF document online
The way to generate an electronic signature for a PDF document in Google Chrome
The way to generate an eSignature for signing PDFs in Gmail
The way to create an electronic signature right from your smart phone
The best way to make an eSignature for a PDF document on iOS
The way to create an electronic signature for a PDF on Android OS
be ready to get more