Fillable Antituberculosis Therapy Program Follow Up on Therapy, F-44125. Antituberculosis therapy and followup information. - dhs wisconsin

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DEPARTMENT OF HEALTH SERVICES Division of Public Health F-44125 (Rev. 08/08) STATE OF WISCONSIN s. 252.10 (7), Wis. Stats. (608) 266-9692 FAX: (608) 266-0049 ANTITUBERCULOSIS THERAPY PROGRAM FOLLOW UP ON THERAPY Complete and return this form when the client completes a recommended course of therapy or discontinues treatment. Completion of this form is required. Failure to complete all information requested on this...
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