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Hepatitis C Risk Assessment

Hepatitis C Risk Assessment

The first step in caring for yourself  is knowing if you may be at increased risk for Hepatitis C. While the questions below are no substitute for an annual check-up with your family physician, it can help to have some idea where you stand in terms of risks for Hepatitis C. Good luck! (If you do not have a physician and you would like to find out more about Hepatitis C, call toll free at  1-888-4GUTHRIE (1-888-448-8474).

 

Questions:

(Click on "Yes" or "No"or enter your personal answer for each question below.) 

1.) have you ever injected illegal drugs, even once many years ago?

Yes  No

2.) Have you ever been treated for clotting problems with a blood product made before 1987?

Yes  No

3.) have you ever been notified that you have received blood from a donor who later tested positive for Hepatitis C?

Yes   No

4.) Have you been a long term hemodialysis patient? 

Yes   No

5.) Do you have signs and/or symptoms of liver disease (e.g., abnormal liver enzymes tests?)

Yes   No

6.) Have you been a healthcare worker who has had exposure to HCV-positive blood? 

Yes   No

7.) Do you have HIV? 

Yes   No

8.) Were you a child born to a HCV-positive mother? 

Yes   No

9.) Did you receive a blood transfusion and/or solid organ transplant before 1992? 

Yes   No

10.) Have you had sexual relations with a chronically infected person or a person at a high risk for HCV? 

Yes   No

If you answered "yes" to one or more questions, you may be at risk for Hepatitis C.  

Please select "Print this page" on the left menu to print this form to discuss it with your Guthrie Physician.

Hepatitis C diagnosis is becoming more complex, and treatments more sophisticated. Guthrie physicians at the Hepatitis C Clinic are trained in a wide variety of approaches to deal with Hepatitis C.



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Guthrie Health - Serving the Twin Tiers Region of Northern Pennsylvania and Southern New York
Last Updated: February 17, 2005