R386-702-8. Required Information

When reporting an event specified in Subsections R386-702-4(2) through R386-702-4(6) to the department, each entity's report shall include: (1) patient information, including the patient's: (a) full name; (b) date of birth; (c) sex; (d) address, including the street address, city, state, and zip code; and (e) phone number; (2) diagnostic information, including the: (a) name of the diagnostic facility; (b) phone number of the diagnostic facility; (c) full name of the ordering or diagnosing health care provider; (d) phone number of the ordering or diagnosing health care provider; and (e) diagnosis or condition being reported; (3) reporter information, including the: (a) name of the person or facility reporting; and (b) phone number of the person or facility reporting; and (4) for any report submitted through eCR or ELR, additional information and reporting specifications described in the: (a) eCR Supplemental Document, incorporated by reference in Section R386-702-3; and (b) ELRSupplemental Document, incorporated by reference in Section R386-702-3; and (5) any additional required information as listed at https://epi.utah.gov/disease-reporting, including any technical document, reporting form, and protocol.