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Get and Sign Form STD 23 Download Fillable PDF or Fill Online Sexually 2020-2022
Of Reportable Sexually Transmitted Diseases Chancroid Neonatal herpes 60 days of age Chlamydia Syphilis Gonorrhea INSTRUCTIONS FOR SUBMITTING STD-23 This form is for reporting sexually transmitted diseases as required under Connecticut General Statute 19a-215 and Public Health Codes 19a-36-A2 through 19a-36-A4. STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH STD CONTROL PROGRAM 410 Capitol Avenue MS 11STD PO Box 340308 Hartford CT 06134-0308 Note Check this box to request forms PATIENT...Show details
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