HAN Public Alerts

Publication Date 
Alert ID 
2019-12-02 10:08 AM46659182Influenza
2019-11-29 1:12 PM46659181Bacterial
2019-11-27 1:53 PM46659278VFC
2019-11-25 11:37 AM46659178Influenza
2019-11-22 5:14 PM46659277Vaping
2019-11-20 10:15 AM46658982Bacterial
2019-11-19 8:23 PM46658981VFC
2019-11-18 12:29 PM46658979Influenza
2019-11-12 12:47 PM46658978Influenza
2019-11-01 3:47 PM46658494Influenza
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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