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Get Report Of Potential Hiv Exposure To Law Enforcement Employees - Cdph Ca

INFORMATION 1. Location/address City 2. County ZIP code Date of incident Time (use 24-hour clock) 3. Type of agency: Correctional Court Other: Law Enforcement Prosecutor City Other: 4. Agency government level: State County 5.* What was the employee s assignment when incident occurred? 6.* Were any criminal laws allegedly violated by the subject? Yes No If yes, specify section(s) violated:.

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