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Get Questionnaire For Avian Flu In Simpl Form

D respirator (such as an N95 or higher mask) Eye Protection Disposable protective foot wear or washable boots Other Health Assessment: Since your first possible contact with avian influenza infected birds, have you developed any of the following symptoms? Symptoms Day 0 (Today s Date: ) Circle One Fever Measured Temp 100F Cough Sore Throat Runny Nose Body Aches * Red or Watery Eyes Diarrhea Headache Drowsiness Other: Dat.

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