PatientDoe, Jane
Patient ID(s)PT-470126 2.16.840.1.113883.19.5
444-44-4444 2.16.840.1.113883.4.1
Contact info Home:
2222 Home Street
Houston, TX 77002, US
Date of BirthOctober 2, 1990
SexFemale
RaceNative Hawaiian or other Pacific Islander
EthnicityNot Hispanic or Latino
Primary Information Recipient:Amanda, Assigned
Contact info Home:
1234 Provider Street
Houston, TX 77002, US
eICR Identifier: 10c13861-86a8-4a9a-aec6-b615921178df

Subject:

Public Health Reporting Communication: one or more conditions are reportable, or may be reportable, to public health.

Summary:

Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient.

"Coronavirus infection (disorder)" is reportable to "Houston Health Department". The initial case report was sent to "Houston Health Department". Additional information may be required for this report.

"Coronavirus infection (disorder)" for "Houston Health Department"

Reporting is required immediately. Reporting to this Public Health Agency is based on "Both patient home address and provider facility address"

> CDC COVID-19 webpage (Information only)

> Houston Health Department Epidemiology Web Page (Information only)