NH Cancer Report free printable template

New Hampshire State Cancer Registry Cancer Report Form Reporting Agency Name Address Telephone Patient Information Name last name first name middle initial Social Security Number Date of Birth Address street address city state zip Race check one Caucasian/White Black Asian Hispanic Native American Other Unknown Sex Yes No Male Female Cancer Information Date of Diagnosis mm/dd/yyyy Where Diagnosed name of hospital physician etc. Primary Site eg. UOQ breast transverse colon Paired Organ check...

How to fill out nh registry report form

How to fill out NH Cancer Report

1. Obtain the NH Cancer Report form from the appropriate health department or website.
2. Gather all necessary patient information, including demographics and contact details.
3. Document the diagnosis information, including cancer type, stage, and date of diagnosis.
4. Include treatment information, specifying types of treatment received and dates of treatment.
5. Fill in follow-up information, including any recurrences or secondary cancers.
6. Review the completed report for accuracy and completeness.
7. Submit the report to the designated cancer registry in New Hampshire by the specified deadline.

Who needs NH Cancer Report?

1. Healthcare providers and hospitals treating cancer patients.
2. Oncologists and cancer registrars responsible for reporting.
3. Public health officials who utilize cancer data for better health programs.
4. Researchers and institutions studying cancer epidemiology and outcomes.

Video instructions and help with filling out and completing new hampshire cancer form

Instructions and Help about cancer registry form fill

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People Also Ask about cancer report form sample

Who collects data for cancer registry?

CDC's National Program of Cancer Registries (NPCR) funds state and territorial cancer registries to collect cancer data to measure progress, drive action, prevent cancers, and improve treatment for all people.

What does a cancer registry do?

A cancer registry is an information system designed for the collection, storage, and management of data on persons with cancer.

What is included in a cancer registry?

Cancer registries maintain a wide range of demographic and medical information: Demographic information: age, gender, race/ethnicity, birthplace, and residence. Medical history: physical findings, screening information, occupation, and any history of a previous cancer.

What are the three types of cancer registries?

These registries can be administrative, research, or cancer control oriented.

Is there a cancer database?

The NCDB is a clinical oncology database sourced from hospital registry data collected in more than 1,500 Commission on Cancer-accredited facilities. These data are used to analyze and track patients with malignant neoplastic diseases, their treatments, and outcomes.

What is a specialty cancer registry?

Special cancer registries maintain data on one aspect or one type of cancer e.g. bone tumors, brain tumors, or pediatric tumors. They often provide educational opportunities for those who want to learn more about a particular type of cancer, and support for those who may suffer from it.

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What is NH Cancer Report?

The NH Cancer Report is a detailed compilation of cancer incidence and mortality data for residents of New Hampshire, which helps in understanding cancer trends and impacts on public health.

Who is required to file NH Cancer Report?

Healthcare providers, including hospitals, laboratories, and clinics that diagnose or treat cancer patients in New Hampshire, are required to file the NH Cancer Report.

How to fill out NH Cancer Report?

To fill out the NH Cancer Report, providers must collect relevant patient data, complete the required forms detailing the diagnosis, treatment, and demographic information, and submit them to the New Hampshire Department of Health and Human Services.

What is the purpose of NH Cancer Report?

The purpose of the NH Cancer Report is to monitor cancer incidence and outcomes in the state, inform public health initiatives, guide cancer research, and facilitate policy development aimed at cancer prevention and control.

What information must be reported on NH Cancer Report?

The NH Cancer Report must include patient demographics (such as age and sex), cancer diagnosis (including type and stage), treatment details, and other relevant healthcare information related to the patient's cancer care.