Get Hhs Suidi Reporting Form

The HHS SUIDI Reporting Form is a crucial document for reporting sudden unexplained infant deaths. This guide provides clear and comprehensive instructions to assist users in accurately filling out the form online, ensuring that all necessary information is captured effectively.

Follow the steps to complete the HHS SUIDI Reporting Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Complete the infant's personal information by filling in their last name, first name, middle name, sex, date of birth, age, race, and case number. Ensure accuracy to facilitate a proper investigation.
3. Provide the infant’s primary residence, including address, city, county, state, and ZIP code. This section should accurately reflect where the infant lived.
4. Detail the incident address by filling in the relevant address, city, county, state, and ZIP code where the event occurred. Providing precise location information is vital.
5. Input the contact information for the witness, including their relationship to the deceased, full name, address, and telephone numbers. This step is important for follow-up communication.
6. Answer the specific questions in the witness interview section regarding usual caregiver status, any unusual behavior of the infant, and circumstances surrounding the infant's last known alive, placed, and found statuses. Respond carefully to each question for thorough documentation.
7. Complete the infant's medical history, including previous medical conditions, significant visits to healthcare providers, and dietary history in the days leading up to the incident. Ensure that all details are truthful and well-documented.
8. Fill out the pregnancy history section detailing the information about the birth mother, prenatal care, and any complications that may have occurred during the pregnancy. This context can be important for understanding the circumstances surrounding the infant's health.
9. Describe the incident scene investigation by providing detailed observations about the location of the incident, including environmental conditions, presence of potential hazards, and other relevant factors. Accurate descriptions help provide clarity in the investigation.
10. Review all filled information for completeness and accuracy to ensure no fields are left unanswered. It is crucial that all sections are thoroughly completed before submission.
11. Once satisfied with your entries, save your changes. You can then choose to download, print, or share the form as necessary, ensuring that all required stakeholders receive a copy of the finalized report.

Complete your HHS SUIDI Reporting Form online today to ensure timely reporting and support for the investigation process.