HAN Public Alerts

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२०२०-०८-०५ १०:०५ पूर्वाह्न46663787Laboratory Information
२०२०-०८-०४ ८:४२ पूर्वाह्न46663679West Nile Virus
२०२०-०७-२७ ७:३० अपराह्न46663510Announcement
२०२०-०७-२७ ११:१३ पूर्वाह्न46663509West Nile Virus
२०२०-०७-२२ ४:०४ अपराह्न46663586STI
२०२०-०७-२० ६:५४ अपराह्न46663582COVID19
२०२०-०७-२० ९:२१ पूर्वाह्न46663502West Nile Virus
२०२०-०७-१३ ३:३३ अपराह्न46663492COVID19
२०२०-०७-१० ३:३२ अपराह्न46663489VFC
२०२०-०७-१० १२:५१ अपराह्न46663488Opioid Concerns
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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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