This Case Investigation Form (CIF), based from the Philippines' Department of Health (DOH) CIF, can be used as COVID-19 contact tracing tool to document pertinent information of a confirmed COVID-19 positive patient and all suspect cases related to the patient. This digital contact tracing form allows contact tracers to easily input information on a mobile device and ensure legibility and security of critical patient details. Once accomplished, data from this form can be easily copied and encoded in an official COVID-10 information system.
About author
Free 1,000+ Workplace Checklists & Templates created by the SafetyCulture team.
You might also like
- Templateby SafetyCulture
Contact Tracing Form Template
A contact tracing form template is a document that helps health professionals determine who a sick person caught an illness from and track every possible person they have been in contact with while infectious. Use this contact tracing form template to ensure the privacy and confidentiality of patient/ visitor information and improve legibility and traceability of crucial contact tracing data.
314 downloadsGet - Templateby SafetyCulture
COVID-19 Risk Assessment Template
Inspired by the CDC's guidance for the identification and management of potentially exposed contacts of a confirmed case of COVID-19, use this risk assessment template to help determine steps to contain the spread of COVID-19.
3871 downloadsGet - Templateby SafetyCulture
COVID-19 Inspection
Use this checklist to ensure you have taken all the preventative measures necessary to stop the spread of Covid-19
5874 downloadsGet - Templateby SafetyCulture
COVID Risk Assessment Tool - Workplace Exposure
Use this COVID Risk Assessment Tool (based on the CDC's Sample Non-Healthcare Worker Interview Questions related to COVID-19 Exposure) to do the following: 1. Gather the occupational information of the employee confirmed to have COVID-19 including modes of transportation, work schedules, and specific work areas 2. Determine whether COVID-19 was transmitted through workplace exposure or community exposure and identify points of close contact 3. Evaluate the completeness of personal protective equipment (PPE) used during work 4. Discuss the presence of high-risk individuals (with regards to age and/or medical conditions) in the employee's household and the steps the employee can take to minimize their risk of exposure such as social distancing within the home or isolation at another facility
31 downloadsGet