Instructions for completing the AFM patient summary form
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.

Search our Collections & Repository

All these words:

For very narrow results

This exact word or phrase:

When looking for a specific result

Any of these words:

Best used for discovery & interchangable words

None of these words:

Recommended to be used in conjunction with other fields

Language:

Dates

Publication Date Range:

to

Document Data

Title:

Document Type:

Library

Collection:

Series:

People

Author:

Help
Clear All

Query Builder

Query box

Help
Clear All

For additional assistance using the Custom Query please check out our Help Page

i

Instructions for completing the AFM patient summary form

Filetype[PDF-409.70 KB]


  • English
    • Details Related Documents You May Also Like

    Details:

    • Alternative Title:
      Instructions for completing the acute flaccid myelitis patient summary form
    • Corporate Authors:
      Centers for Disease Control and Prevention (U.S.)
    • Description:
      Clinicians should report all patients who meet the case definition (as specified on page 4) for AFM to their state or local health department using this Patient Summary Form.

      a. Clinicians should report patients who meet the case definition regardless of any laboratory results.

      b. This form should be completed by, or in conjunction with, a clinician who provided care to the patient during the neurologic illness.

      c. So that cases can be monitored in as real time as possible, this form should be submitted to the state or local health department as soon as possible after case identification.

      CDC requests that state health departments also submit the Patient Summary Form to CDC to help monitor these cases at the national level. A form that is largely complete but has some information pending (e.g., hospital or health department laboratory results) or under investigation (e.g., polio vaccination history) should still be submitted as soon as possible, and the pending results can then be provided to CDC when they become available.

      patient-summary-form-instructions.pdf

    • Subjects:
    • Document Type:
      Pamphlet (or booklet)
    • Collection(s):
    • Main Document Checksum:
    • Download URL:
    • File Type:

    Supporting Files

    • No Additional Files

    More +

    Related Documents

    You May Also Like

    Checkout today's featured content at stacks.cdc.gov