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Routine Surveillance in Maine
•In Maine, the Notifiable Condition Reporting Form must include:
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–Disease or condition
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–Demographic information for the case-person
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–Diagnostic laboratory findings
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–Healthcare provider’s name & contact information
Speaking Points

•This slide shows the Notifable Condition Reporting Form from Maine Department of Human Services, Bureau of Health, Division of Disease Control

•This form is for use in reporting Category 2 Notifiable Conditions only, as all Category 1 Notifiable Conditions must be reported by telephone. However, the information required is the same whether reporting by telephone or using the form

•The data required include:
•The disease or condition diagnosed or suspected
•The case-person’s name, date of birth, address, telephone number, occupation, and race
•Diagnostic laboratory findings and dates of tests relevant to the notifiable condition
•The health care provider’s name, address, and telephone number
•The name and telephone number of the person making the report