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Screeening Forms

Hepatitis Charting

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This resource provides a straightforward tool to use to develop effective hepatitis risk assessment with adult clients through your clinic charting system.

Domestic Violence Screening Low Literacy Form

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This is a one page tool used by community health workers to evaluate individuals for family violence. The tool is designed for use with low literacy populations and uses pictures instead of words to communicate.

Evaluation Tool for Physical Abuse, English and Spanish

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One page tool to use in evaluating the possibility of physical abuse.

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