This form is to be used by health care providers to report Lab Confirmed Positive COVID-19 cases to the Fresno County Department of Public Health.

(July 7, 2020: Suspected cases are no longer required to be reported, only lab confirmed cases are required to be reported at the current time)

*If you are not a health care provider or lab, do not use this form.*

‘Health care provider’ is defined as a physician, surgeon, veterinarian, podiatrist, nurse practitioner, physician assistant, registered nurse, nurse midwife, school nurse, infection control practitioner, medical examiner, dentist, etc.

When dealing with a patient with a Febrile Respiratory Illness please:

    1. Give Isolation Order and Instruction Packet to Patient
    2. Instruct patient verbally to self isolate
    3. Instruct patient that all close contacts need to quarantine for 14 days

Reporting Requirements:

Providers are required to report all laboratory confirmed cases of COVID-19 cases to the Local Health Department. Preferred method is though the CalREDIE provider portal (More information here) but cases can also be reported using this form. Please also report all COVID-19 deaths by phone call during business hours to the LHD COVID-19 Provider Line at (559) 600-3332.

Loading... Loading...
You have selected an option that triggers this survey to end right now. To save your responses and end the survey, click the button below to do so. If you have selected the wrong option by accident and do not wish to leave the survey, you may click the other button below to continue, which will also remove the value of the option you just selected to allow you to enter it again and continue the survey.
The response has now been removed for the last question for which you selected a value. You may now enter a new response for that question and continue the survey.