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Get Medsis Id Form

Ons. In addition, complete Section 4 for STDs and HIV/AIDS cases, Section 5 for hepatitis, and Section 6 for tuberculosis. Once completed, return to your county or tribal health agency. If reporting through MEDSIS, go to https://my.health.azdhs.gov/. 1. PATIENT INFORMATION Patient s Name (Last, First, Middle) Date of Birth Street Address: Race (check all that apply): White Pacific Islander Black Native American Asian Other City: Patient s Occupation or School: State: Guardian: (not n.

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