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California Department of Public Health State of California - Health and Human Services Agency LHJs should fax this form to[removed]
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Document Date: 2014-08-01 16:18:08

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Facility

hospital ED / e.g. hospital / /

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IndustryTerm

risk groups / /

MedicalCondition

season’s influenza / Secondary bacterial infection / Pneumonia / laboratory-confirmed influenza / Pulmonary embolus / e.g. hypertension / Cardiac disease / Chronic pulmonary disorder / e.g. diabetes mellitus / Encephalitis/encephalopathy / Hemoglobinopathy / Metabolic disorder / Genetic disorder / Neurological disorder / e.g. cerebral palsy / e.g. cancer / Influenza / Acute renal failure / Sepsis / e.g. sickle cell disease / hyperlipidemia / /

MedicalTreatment

hemodialysis / chemotherapy / Immunosuppression / /

MusicGroup

DFA / /

Organization

California Department of Public Health State of California / California Department of Public Health / /

Position

reporter / /

ProvinceOrState

ARDS / California / /

Technology

chemotherapy / /

SocialTag