Get Uy Fo-13321-003 2017-2026

Filling out the UY FO-13321-003 form is a crucial step in reporting and investigating suspected epidemiological cases. This guide aims to walk you through the process of completing the form accurately and efficiently, ensuring all necessary information is captured.

Follow the steps to complete the UY FO-13321-003 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the notification date in the specified format (___/___/___). Then, indicate the start date of symptoms, date of consultation, and whether hospitalization occurred by checking 'YES' or 'NO'. If hospitalized, provide the institution and admission date.
3. In the 'Datos del caso' section, fill in the case identifier (CI), full name in capital letters, gender selection (using 'F' for female, 'M' for male), date of birth, and age in years, months, and days. Include the barrio (neighborhood), address, department, location, and contact number.
4. Complete the 'Datos del notificador' section with your name and surname. Specify your role in the notification process, and provide your cell phone number.
5. In the 'INFORMACIÓN COMPLEMENTARIA' section, check the box next to any clinical data that applies. Include relevant details like the onset date of fever if applicable, and document additional clinical symptoms by checking 'YES' or 'NO' for each item.
6. Provide vaccination history by indicating whether the individual has received the triple viral and triple bacterial vaccines, along with the dates of the last doses.
7. Address any epidemiological history by noting if there was contact with suspected or confirmed cases of disease. If 'YES', specify the individuals involved. Also, include any pertinent details on skin injuries if applicable.
8. Indicate if a confirmatory study was performed and specify the type, along with the results if applicable.
9. In the 'Evolución del caso' section, specify if the case required ICU hospitalization. Include any observations and the outcome such as discharge or death.
10. Once all fields are completed, save your changes. You can also download, print, or share the form as needed.

Complete the UY FO-13321-003 form online to ensure proper documentation and reporting.