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Acute Hepatitis B or C Case Report Mobile App

The Center for Infectious Diseases, Division of Communicable Disease Control, requires the information within this app and is intended for use by health professionals only. Reportable Diseases and Conditions for specific diseases and conditions are mandated by state laws and regulations to be reported by healthcare providers and laboratories to local health officers. The Acute Hepatitis B or C Case Report mobile app provides an easy to complete paperless version of the mandated case report form specific to Acute Hepatitis B or C. The app is filled out using a smartphone or tablet. This GoCanvas app can be made HIPAA compliant and is ideal for Disease Surveillance and Reporting.

The Center for Disease Control, national centers, children’s hospital, public health and local health departments urge health care providers to promptly report infectious diseases as well as virus infections. It is important for patient safety. Pregnant women, immigrant children, illegal immigrants and travelers are at a greater risk for communicable diseases and birth defects from lack of infection control and virus transmission. This app is specific to Acute Hepatitis B or C please don’t hesitate to report any suspicious respiratory illness, flu, rash, pneumonia or virus infection. Timely reporting can stop outbreaks.

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

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Take a peek inside the Acute Hepatitis B or C Case Report Mobile App

Included Features

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Included Fields

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

  • Ico textbox

    Last Name

  • Ico textbox

    First Name

  • Ico textbox

    Middle Name

  • Ico textbox

    Suffix

  • Ico textbox

    Social Security Number (9 digits)

  • Ico date

    DOB

  • Ico decimal

    Age

  • Ico checkbox

    Years

  • Ico checkbox

    Months

  • Ico checkbox

    Days

  • Ico textbox

    Address Number & Street - Residence

  • Ico textbox

    Apartment/Unit Number

  • Ico textbox

    City/Town

  • Ico dropdown

    State

  • Ico integer

    Zip Code

  • Ico textbox

    Census Tract

  • Ico textbox

    County of Residence

  • Ico textbox

    Country of Birth

  • Ico date

    If not U.

  • Ico textbox

    Home Telephone

  • Ico textbox

    Cellular Phone/Pager

  • Ico textbox

    Work/School Telephone

  • Ico textbox

    E-mail Address

  • Ico textbox

    Other Electronic Contact Information

  • Ico textbox

    Work/School Location

  • Ico textbox

    Work/School Contact

  • Ico dropdown

    Gender

  • Ico textbox

    Other:

  • ...and More!

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