JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
HCV Point-of-Care Results
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Patient ID
*
Your answer
Anti-HCV Point-of-Care - (0=negative; 1=positive)
*
0
1
Initials of Recorder
*
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of American Pacific Health Foundation.
Report Abuse
Forms
