Transcription of Surveillance Form for Tick Identification
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Surveillance Form for Tick Identification
Surveillance Form for Tick IdentificationNOTE: Tick testing will be used for Surveillance activities. As per Infectious Disease Society of America (IDSA) guidelines, tick testing should not be used for diagnosis and management of Lyme Sections of this form must be completedFor laboratory use onlyDate receivedyyyy / mm / ddPHOL ) *Where was the tick most likely acquired (Be as specific as possible, , town, park, province, or city):c) When was the tick collected or removed?:e) How long was the tick attached (feeding)(state hours or days)b) Did you travel in the previous two weeks? (Check one)*:d) Was the tick attached (feeding)*The information in fields a) and b) is mandatory and is essential to the tick Surveillance program.
Surveillance Form for Tick Identification NOTE: Tick testing will be used for surveillance activities. As per Infectious Disease Society of America (IDSA) guidelines, tick testing should not be used for diagnosis
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FORCE INTELLIGENCE, SURVEILLANCE AND, FORCE INTELLIGENCE, SURVEILLANCE AND RECONNAISSANCE AGENCY, ENR 1, Surveillance, Model Medical Surveillance Program, WHO Recommended Surveillance Standards, Guidelines for drinking-water quality, World Health Organization, Surveillance Intelligence and Technology