HAN Public Alerts

Publication Date 
Alert ID 
2562-12-09 9:44 ก่อนเที่ยง46659183Influenza
2562-12-02 10:08 ก่อนเที่ยง46659182Influenza
2562-11-29 1:12 หลังเที่ยง46659181Bacterial
2562-11-27 1:53 หลังเที่ยง46659278VFC
2562-11-25 11:37 ก่อนเที่ยง46659178Influenza
2562-11-22 5:14 หลังเที่ยง46659277Vaping
2562-11-20 10:15 ก่อนเที่ยง46658982Bacterial
2562-11-19 8:23 หลังเที่ยง46658981VFC
2562-11-18 12:29 หลังเที่ยง46658979Influenza
2562-11-12 12:47 หลังเที่ยง46658978Influenza
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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