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Amazing Facts






 

Hepatitis-B risk: Self-test

 

1.Medical History
Currently, or in the past, have you experienced any of the following?
. Blood transfusion prior to 1975
. Chronic fatigue/tiredness for which your doctor was unable to find an explanation
.Any surgery, including oral surgery
. Endoscopy or other exploratory procedure (oral, nasal, rectal)
.Cesarean delivery or other obstetric or gynecological surgical intervention
.Diagnosis of HIV-positive
.Kidney dialysis
.Elevated liver enzymes test (ALT)
.Diagnosis of hepatitis B or hepatitis C
 
  Yes   No
 
2.Work History
Does your work ever put you in contact with blood, blood products, or needles? Examples include:
. Armed Forces: Army, Navy, Air Force, Reserves, VA Hospital or Home, Coast Guard
. Health Care: Doctors, Nurses, Dentists or Dental Workers, Oral Surgeons, Hospital Cleaning Services
. Emergency Services: Police Officers, Firefighters, Paramedics
. Prison Services: Corrections Officers, Firefighters, Paramedics
. Science Laboratories
. Clinical Laboratories
. Beauticians, Barbers
. Institution Workers: Nursing Homes/Elderly Care, Psychiatric Hospitals, Substance Abuse Centers, Hospices.
 
  Yes   No
 
3.Lifestyle
        Currently, or in the past, have you:
. Had a tattoo?
. Had any part of your body pierced?
. Had acupuncture?
. Been in the military?
. Changed sex partners frequently?
. Inhaled cocaine?
. Been in prison?
. Injected drugs (even once)?
. Had a problem with alcoholism?
. Had unprotected sex with anybody who you know would fit any of the descriptions above?
 
  Yes  No
 
3.Family History
Do any of the above descriptions apply to a member of your immediate family, or has a member of your immediate family been diagnosed with hepatitis B or hepatitis C?
 
  Yes   No
 
 



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