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STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION HEPATITIS C TREATMENT INFORMED REFUSAL/INELIGIBILITY (SPANISH) CDC 74142 Sp (Rev. 03/14) Form: Page 1 of 1 RICHARD/INELEGIBILIDAD INFORMED

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How to fill out cdcr 7414-2 sp hepatitis

01

To fill out the CDRC 7414-2 SP Hepatitis form, follow these steps: 1. Begin by providing your personal information such as your name, date of birth, and contact details. 2. Indicate your current status by selecting the appropriate option, whether you are an inmate or staff member. 3. Specify the date of the potential exposure to hepatitis. 4. Answer the questions related to symptoms experienced, if any. 5. If applicable, provide details of any medical treatments received and their dates. 6. Sign and date the form to certify that the information provided is accurate.

Who needs cdcr 7414-2 sp hepatitis?

01

The CDRC 7414-2 SP Hepatitis form is required by individuals who have potentially been exposed to hepatitis. This includes both inmates and staff members of correctional facilities. The form helps in tracking and monitoring potential hepatitis cases within the facility as well as ensuring appropriate medical care and treatment.

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What is cdcr 7414-2 sp hepatitis?

cdcr 7414-2 sp hepatitis is a form used by the California Department of Corrections and Rehabilitation to report cases of hepatitis among inmates.

Who is required to file cdcr 7414-2 sp hepatitis?

Healthcare providers in correctional facilities are required to file cdcr 7414-2 sp hepatitis.

How to fill out cdcr 7414-2 sp hepatitis?

To fill out cdcr 7414-2 sp hepatitis, healthcare providers must provide details about the inmate, their diagnosis of hepatitis, treatment received, and any relevant medical history.

What is the purpose of cdcr 7414-2 sp hepatitis?

The purpose of cdcr 7414-2 sp hepatitis is to track and monitor cases of hepatitis within correctional facilities to ensure proper treatment and prevent further spread.

What information must be reported on cdcr 7414-2 sp hepatitis?

Information such as inmate name, ID number, diagnosis of hepatitis, treatment plan, and any relevant medical history must be reported on cdcr 7414-2 sp hepatitis.

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