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Lyme Disease Investigation - Department of Health (New Jersey) Mobile App

The surveillance definition of Lyme disease as specified by the Centers for Disease Control is : 1) Erythema migrans, or 2) at least one late manifestation of Lyme disease and laboratory confirmation of infection. Late manifestations of Lyme disease include those muscloskeletal, neurologic or cardiac symptoms as listed under Section IV of this form. Other information captured includes lab data, patient information, and the treating physician.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Lyme Disease Investigation - Department of Health (New Jersey) Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Name

  • Ico date

    Date of Birth

  • Ico textbox

    Age

  • Ico dropdown

    Sex

  • Ico dropdown

    Ethnicity

  • Ico multiline

    Address

  • Ico textbox

    County

  • Ico textbox

    Municipality of Residence:

  • Ico textbox

    Telephone Number:

  • Ico textbox

    Name of Health Department:

  • Ico textbox

    Name of Investigator:

  • Ico textbox

    Telephone No.

  • Ico textbox

    Name:

  • Ico textbox

    Agency:

  • Ico textbox

    Telephone No.

  • Ico textbox

    Name:

  • Ico multiline

    Address:

  • Ico textbox

    Telephone Number:

  • Ico date

    Date of Onset:

  • Ico statictext

    Check all that apply:

  • Ico statictext

    A.

  • Ico checkbox

    Erythema migrans (Size: >5 cm)

  • Ico statictext

    B.

  • Ico checkbox

    Arthritis characterized by brief (weeks or months) attacks of object joint swelling

  • Ico statictext

    C.

  • Ico checkbox

    Cranial neuritis

  • Ico checkbox

    Lymphocytic meningitis

  • Ico checkbox

    Radiculoneuropathy

  • ...and More!

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