HAN Public Alerts

Publication Date 
Alert ID 
Topic 
Title 
2019-11-12 12:47 odp.46658978Influenza
2019-11-01 3:47 odp.46658494Influenza
2019-10-25 2:42 odp.46658492Influenza
2019-10-24 4:15 odp.46658787Situational Awareness
2019-10-24 2:04 odp.46658785VFC
2019-10-21 10:06 dop.46658490Influenza
2019-10-18 4:00 odp.46658489Announcement
2019-10-18 8:44 dop.46658488Announcement
2019-10-16 12:32 odp.46658487Vaccine Shortage
2019-10-15 11:31 dop.46658483Infectious Disease
false null [0, 1, 2, 3]

inter-facility infection prevention transfer form

An inter-facility infection prevention transfer form has been developed as part of a regional effort to improve communication between acute and long-term healthcare facilities. The purpose of the form is to convey information about a patient’s isolation precautions and the reason for their implementation to the receiving facility. The sending facility should record current infection and colonization information. The form is not intended to be a comprehensive documentation of microbiologic history and does not replace review of medical records and communication between care providers. 

Please fill out this form and send it with all patients being transferred between facilities, regardless of whether or not they require isolation.

Please click here for the form.

Questions or feedback about the form may be addressed by the CDPH HAI Unit: cdphhaiar@cityofchicago.org

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