Appendix G

What to know

Please note, some of the examples in the Appendices may be outdated and may have changed. Those changes may not be reflected in this document.

Example #1: Courtesy of Colorado Bureau of Public Health

Documentation Log
Partner # Email Date Website Name Partner’s Email Email Script # AM Logon Time PM Logon Time Notes/Outcome of Activity Disease Verification (3rd Email) Closure Code
 
 
 

Your Name:
DIS # & State:
Initiation Date:
OP Id # and Disease:

Internet-based Partner Services Supervisory Website Log
Date Website Log In Time Log Out Time Purpose Staff/Sups Initials
 
 
 

Example #2: Courtesy of Arkansas Department of Health

INTERNET-BASED PARTNER NOTIFICATION LOG SHEET
Field Record # Date Recd P1 to: Screen Name/ Email Address Website Dis No. Attempt and Outcome #1 Attempt and Outcome #2 Attempt and Outcome #3 Dispo/Date SN DB Notes

Month: __________________        Year: __________________