INFECTIOUS DISEASE RISK ASSESSMENT FORM - Oregon
To help find out if you are at increased risk for HIV, the virus known to cause AIDS, or Hepatitis C Virus (HCV), please take a minute to answer the following questions. 20. Yes No Don’t know Did you receive a blood transfusion before 1992? 21. Yes No Don’t know Have you received blood products produced before 1987 for clotting problems? 22. ................
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