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Evaluation

Are you trying to determine if testing for hepatitis C viral infection is indicated in a person?

Age of the person

years

Date of birth (enter MM/DD/YYYY)

Gender of person

Did the person receive a transfusion of blood or a blood component before July, 1992?

Did the person receive clotting factor concentrates produced before 1987?

Did the person receive an organ (heart, lung, kidney, liver, pancreas) transplant before July, 1992?

Did the person receive transplanted non-organ tissue such as cornea, skin, bone, tendon, ova or sperm?

Has the patient undergone chronic hemodialysis?

Is the patient infected with HIV?

Has the person had a persistently elelvated ALT level?

Has the person ever injected illegal drugs?

Did the person ever use noninjected illegal drugs such as intranasal cocaine?

Is the person a healthcare, emergency medical or public safety worker?

Has the person had an exposure (needle stick, sharps exposure, mucosal exposure) to body fluid from someone possibly HCV infected?

Is the person pregnant?

Is the person a household contact of someone who is HCV-positive person?

Was the person born to an HCV-positive woman?

Does the person have a history of multiple sex partners?

Does the person have a history of sexually transmitted disease?

Is the person a sex partner of someone who is HCV-positive?

Has the person been tattooed or undergone body piercing?

Results

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