Answer to Question 1
Any three of the following:
transfer date
name, address, and phone number of the transferring facility and receiving facility
inmate's name, identification number, date of birth
date of last physical
known allergies
date of last tuberculin test and results
behavioral or mental health conditions, suicide attempt, or gesture during current or prior incarceration
medical conditions
current medications, including medication name, dose, frequency
restrictions (if any) on activities, diet, housing, other
adaptive devices
HIV status
Current dental problems
Follow-up appointments
Signature of individual preparing the health summary transfer form and the signature of the person receiving the health transfer information.
Answer to Question 2
TRUE