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Checklist for Healthcare Providers re Suspected CJD Cases Mobile App

Medical providers are required to notify local or state public health department within 3 working days if CJD, variant CJD, or other TSE is suspected as a cause of the patient’s illness. The local public health district can assist you with many of the tasks in the Checklist for Healthcare Providers re Suspected CJD Cases mobile app. You can set up unique numbering for each GoCanvas App you have in your account.

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

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Take a peek inside the Checklist for Healthcare Providers re Suspected CJD Cases Mobile App

Included Features

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Included Fields

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

  • Ico checkbox

    Notify local or state public health department within 3 working days if CJD, variant CJD, or othe...

  • Ico checkbox

    Discuss autopsy with patient and/or family.

  • Ico checkbox

    Determine who has authority over the remains (see Idaho Code Section 54-1142, http://www3.

  • Ico checkbox

    Possible referral to establish durable power of attorney for health care.

  • Ico checkbox

    Discuss genetic testing with patient and/or family.

  • Ico checkbox

    Possible referral to a genetic counselor (see http://www.

  • Ico checkbox

    Possible referral to CJD Foundation for family support, including help with making decisions on a...

  • Ico checkbox

    Contact National Prion Disease Pathology Surveillance Center (NPDPSC), tel.

  • Ico checkbox

    Complete NPDPSC forms, available on-line at http://www.

  • Ico checkbox

    Autopsy consent form.

  • Ico checkbox

    Test request form.

  • Ico checkbox

    Testing and reporting form.

  • Ico checkbox

    Provide contact for autopsy arrangements to NPDPSC.

  • Ico checkbox

    Provide clinical history of the patient to the NPDPSC.

  • Ico checkbox

    Summary of medical information and progress notes since the date on onset

  • Ico checkbox

    Information and results from EEGs and MRIs (on disk)

  • Ico checkbox

    Summary of relevant family history

  • Ico checkbox

    Notification to funeral service director of precautions to take.

  • Ico checkbox

    All testing and NPDPSC-approved autopsies are performed free of charge to the patient and the pat...

  • Ico checkbox

    Autopsies should ideally be done within 72 hours of death; if this cannot be achieved than the bo...

  • Ico checkbox

    Autopsies can be done at St.

  • Ico checkbox

    National Prion Disease Pathology Surveillance Center, including protocols for specimen submission...

  • Ico checkbox

    World Health Organization information on prion disease diagnostics, patient care, clinical criter...

  • Ico checkbox

    Idaho Department of Health and Welfare information on CJD in Idaho: http://www.

  • Ico checkbox

    CJD Foundation, which provides support to families of CJD patients: http://www.

  • Ico checkbox

    American Red Cross blood donor eligibility: http://www.

  • Ico checkbox

    Genetic testing information: http://www.

  • Ico checkbox

    Centers for Disease Control and Prevention CJD website: http://www.

  • ...and More!

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