STD Clinic Record (Female)

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Author: Broome County Health Department Clinic Services

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STD Clinic Record Broome County HD c20061 id563

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This is a STD history record form template used by the Broome County Health Department as a guide to document patient history for females who are being seen for the first time.

Program: Community Health

Submitted Date: Feb 27, 2007 | Modified Date: Sep 30, 2025

Primary Toolkit: HIV/STI Toolkit | Secondary Toolkit: HIV/STI Toolkit

Jurisdiction:

Institution Type: LHD - County,

Keywords: Infectious Disease, Epidemiology, HIV, STI, and Viral Hepatitis

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