Disclosure Statement

PLEASE NOTE that Project ECHO® case consultations do not create or otherwise establish a provider-patient relationship between any WVU clinician and any patient whose case is being presented in a Project ECHO setting. Always use ECHO ID# when presenting a patient in clinic. Sharing patient name, initials or other identifying information violates HIPAA privacy laws.

Hepatitis C Case Presentation Form

General Information/Demographics

Case Presentation

Hepatitis Vaccinations

Body Mass Index

Basic Laboratory Results

Additional Laboratory Results

Additional Information

Does this case need to be addressed urgently?

Instructions

If you have any questions regarding the ECHO project, please send an email to Jay Mason, Mithra Mohtasham, or Elisabeth Minnick.