HAN Public Alerts

Publication Date 
Alert ID 
Topic 
Title 
2019-09-17 4:12 PM46658383Situational Awareness
2019-09-17 10:36 AM46658290Tuberculosis and Other Mycobacterial
2019-09-17 9:40 AM46658289Announcement
2019-09-16 1:34 PM46658381Influenza
2019-09-16 1:29 PM46658380Influenza
2019-09-13 11:59 AM46658288Announcement
2019-09-10 9:44 AM46658286CCN Announcement
2019-09-09 1:45 PM46658285Announcement
2019-09-04 12:39 PM46658280VFC
2019-08-30 4:49 PM46658278Public Health Recommendations and Evaluations
false null [0, 1, 2, 3]

Inter-facility Infection Control Transfer Form

An inter-facility infection prevention transfer form has been developed as part of a regional effort to improve communication between acute and long-term healthcare facilities. The purpose of the form is to convey information about a patient’s isolation precautions and the reason for their implementation to the receiving facility. The sending facility should record current infection and colonization information. The form is not intended to be a comprehensive documentation of microbiologic history and does not replace review of medical records and communication between care providers. 

Please fill out this form and send it with all patients being transferred between facilities, regardless of whether or not they require isolation.

Please click here for the form.

Questions or feedback about the form may be addressed by the CDPH HAI Unit: cdphhaiar@cityofchicago.org

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