HAN Public Alerts

Publication Date 
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2019-10-18 4:00 PM46658489Announcement
2019-10-18 8:44 AM46658488Announcement
2019-10-16 12:32 PM46658487Vaccine Shortage
2019-10-15 11:31 AM46658483Infectious Disease
2019-10-11 4:28 PM46658782Influenza
2019-10-11 2:40 PM46658783Vaping
2019-10-11 11:39 AM46658482Influenza
2019-10-09 3:45 PM46658781CCN Announcement
2019-10-09 3:35 PM46658780CCN Announcement
2019-10-01 9:53 AM46658481VFC
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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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