Integrated Measles and Rubella Case Investigation Form

Form Template

Local health departments conduct health investigations as part of prevention and response programs for infectious disease control.

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The Integrated Measles and Rubella Case Investigation Form app is a recommended set of questions for case-based reporting in measles and rubella surveillance. With the app, a health investigator records personal data and immunization records including vaccination status, vaccination dates for both the measles vaccine and the rubella vaccine. With the clinical information section, the investigator will check for signs and symptoms of measles, maculopapular rash, high fever, or cough. With the epidemiologic investigation, the investigator will gauge whether the patient had contact with someone with the disease prior to the onset of a maculopapular rash, if there have been confirmed cases of measles in the area, and if the patient has traveled or came into contact with any pregnant women. Finally, the investigator will record the results of laboratory investigation such as testing of measles IgM or rubella IgM, any virus detection, and identify a final classification of the patient's infection.

Features
  • Signature Capture
  • Image Capture
  • Conditional Fields
  • Submission Editing
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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