What is a Confidential STD Morbidity Report Form?
To understand the use of a Confidential STD Morbidity Report Form, it is crucial to understand the meaning of a Confidential Morbidity Report or a CMR. A CMR is used to inform the Public Health Department of diseases and medical conditions that you suffer from.
It covers a number of diseases and conditions which, upon discovery, must be informed to the department by filling and submitting a CMR form.
One such form is the Confidential STD Morbidity Report Form. Through this form, information on the detection of an STD has to be disclosed to the Public Health Department for the safety and security of millions of people coming in contact with the individual.
Information required on a Confidential STD Morbidity Report Form
The said form requires the personal, contact details & Social Security Number of the person reporting the disease, the name of the clinic/ hospital that tested the individual & released the medical reports, and the date on which the form is being submitted.
It also requires the person to disclose their sex, race, marital status, pregnancy status, and the reason behind getting tested for an STD.
Along with stating the details of the STD detected, it is also to be disclosed whether there are chances of any other related diseases being detected.
If needed, laboratory reports should be submitted along with the Confidential STD Morbidity Report Form. Irrespective, laboratory data must be mentioned in the specified section of the form.
That being said, the treatment that is being taken for the reported disease has to be mandatorily informed. If the individual has suffered from the same or related disease in the past, the treatment taken for the same must also be revealed.
How to Fill Out a Confidential STD Morbidity Report Form
Like many other official forms being available online, the Confidential STD Morbidity Report Form is also available on various websites. It is a single-sheet form that has to be filled and submitted to the Public Health Department. It might or might not be attached with certain other health documents. A Confidential STD Morbidity Report Form looks like this.
- Start by filling out the date of the form submission followed by personal details of the individual.
- Specify the facility or clinic that you got yourself tested from.
- The form will require your Social Security Number as well. Mention your Race and Hispanic descent against the specified boxes.
- Move on to fill in your contact details and your emergency contact person.
- The form also asks about your marital status and pregnancy status. Make sure to fill those out correctly.
- You will need to write the reason for getting yourself tested for an STD.
- A section is dedicated to mentioning your laboratory report data. Mention in detail the treatment methods you used if and when you were diagnosed previously.
- In the next table, disclose the current treatment information, the doses, and the treatment provider.
- In the notes section, mention any fact or information that you feel is important and could not be covered in the form.
Make sure to fill out every information cautiously and correctly so as to not misguide the Public Health Department. Your attentive reporting to the department might be helpful to you and to the public. It is also advised that you keep one copy of the form for yourself.
What is the Confidential STD Morbidity Report Form Used for?
The Confidential STD Morbidity Report Form is used to disclose information to the Public Health Department that can secure and save the lives of the people. It is used to disclose an STD detected by an individual that can potentially harm the public.
It is also used for the Public Health Department to be aware that the individual is taking relevant treatment measures to contain the disease from harming the individual further and spreading among the people.
