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Case report forms

The purpose of a case report form is:

  • To collect appropriate data by disease
  • To provide a structure for conducting an investigation
  • To collect minimum detail to provide:
    • picture of person, place and time
    • dimensions of disease occurrence in a community

Features of the forms include:

  • Paper forms that match data entry screens
  • Modular design, including:
    • Reporting authority
    • Notifier identification
    • Case identification
    • Case demography
    • Clinical course and outcome
    • Outbreak details
    • Basis of diagnosis
    • Risk factors
    • Protective factors
    • Management
  • Core data (*) and optional data (~)