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Infectious Disease Epidemiology Section Office of Public Health, Louisiana Department of Health 8002562748 (24 hr. number) (504) 5688313 www.infectiousdisease.dhh.louisiana.govHepatitis A Revised
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How to fill out hepatitis a - louisiana
How to fill out hepatitis a - louisiana
01
To fill out the Hepatitis A form for Louisiana, follow these steps:
02
Begin by downloading the Hepatitis A form from the official Louisiana Department of Health website.
03
Read the instructions carefully to understand the required information and supporting documents.
04
Provide your personal details including full name, date of birth, address, and contact information.
05
Answer all the medical history questions honestly and accurately.
06
If applicable, provide details of any previous hepatitis A vaccinations you have received.
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Attach any required supporting documents, such as proof of residency or vaccination records.
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Review the completed form to ensure all the information is filled out correctly.
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Sign and date the form.
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Make a copy of the completed form for your records.
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Submit the form by mailing it to the designated address or following the submission instructions provided on the form.
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Note: It is recommended to consult with a healthcare professional or the Louisiana Department of Health for specific guidance and any updates regarding the Hepatitis A form.
Who needs hepatitis a - louisiana?
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Hepatitis A vaccination is recommended for various groups of people in Louisiana, including:
02
- Individuals traveling to or living in areas with high rates of Hepatitis A
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- Men who have sex with men
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- People who use or inject drugs
05
- People with chronic liver disease, such as Hepatitis B or C
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- Individuals who have clotting-factor disorders
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- People experiencing homelessness
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- Those in close contact with someone infected with Hepatitis A
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- Individuals working in healthcare or laboratory settings
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It is advisable to consult with a healthcare provider or the Louisiana Department of Health to determine if you specifically need the Hepatitis A vaccine.
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