Hepatitis C Provider Case Report Form

The viral infection causes liver inflammation and, in some cases, can lead to serious liver damage. Symptoms of the infection can include fatigue, nausea, and loss of appetite. Most people have no symptoms. The Hepatitis C Provider Case Report Form app is used to document any acute, chronic, or cleared Hepatitis C virus infection. With the app, the health care provider will provide patient information and will be guided through a checklist for signs and symptoms of the virus such as abdominal pain and jaundice. The provider will document any Hepatitis C virus testing including antibody testing, supplemental anti-HCV assay, and liver enzyme levels. The health care provider will indicate the laboratory test conducted and the results of the laboratory test. The app user will review a list of risk factors or reasons for testing and check all those that apply, denoting pregnant women with the potential transmission of HCV or health care workers who come into contact with blood from a person who has the infection.