* Armed Forces: Army, Navy, Air Force, Reserves, VA Hospital or Home,
Coast Guard
* Health Care: Doctors, Nurses, Dentists, or Dental Workers, Oral Surgeons,
Hospital Cleaning Services
* Emergency Services: Police Officers, Firefighters, Paramedics
* Prison Services: Corrections Officers, Prison Cleaning Services
* Science Laboratories
* Clinical Laboratories
* Tattooists
* Beauticians, Barbers
* Institution Workers: Nursing Homes/Elderly Care, Psychiatric Hospitals,
Substance Abuse Centers, Hospices
Medical History:
Currently, or in the past, have you experienced any of
the following?
* Blood transfusion prior to 1992
* Chronic fatigue/tiredness for which your doctor was unable to find
an explanation
* Any surgery, including oral surgery
* Endoscopy or other exploratory procedure (oral, nasal, rectal)
* Cesarean delivery or other obstetric or gynecological surgical intervention
* Diagnosis of HIV-positive
* Kidney dialysis
* Elevated liver enzymes test (ALT)
* Diagnosis of hepatitis B or hepatitis C
Lifestyle:
Currently, or in the past, have you:
* Had a tattoo?
* Had any part of your body pierced?
* Had acupuncture?
* Received a shave in a barbershop?
* Been in the military
* Changed sex partners frequently?
* Inhaled cocaine?
* Been in prison?
* Injected drugs (even once)
* Had a problem with alcoholism?
* Had unprotected sex with anybody who you know would fit any of the
descriptions above?
Family History:
Do any of the above descriptions apply to a member of
your immediate family, or has a member of your immediate family been diagnosed
with hepatitis B or hepatitis C?
Get Tested:
If you answered "yes" to any of these questions, ask
your doctor about being tested; in many instances, hepatitis can be treated.
Call the AMERICAN LIVER FOUNDATION for more information: 1-800-223-0179
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