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Background Primary care providers (PCPs) must identify persons at risk for hepatitis C virus (HCV) infection, test them correctly, refer to subspecialists, and use published guidelines. The objectives of this study were to describe HCV practices of New Haven County PCPs. Study All 652 PCPs in New Haven County, Connecticut, were surveyed to determine practices related to hepatitis C, including risk factor ascertainment, testing routines, use of published guidelines, and referral practices. Results Of 181 eligible respondents, 143 (79%) were internal medicine physicians and 38 (21%) were family practitioners. Eighty-four PCPs (46%) routinely asked about a history of blood transfusion, and 112 (62%) routinely asked about a history of injection drug use (IDU). Most PCPs would test current or past IDU (91% versus 83%, respectively), persons transfused prior to 1992 (79%), health care workers with a history of a needle stick accident (88%), and a child born to an HCV-infected mother (76%). PCPs frequently referred patients with hepatitis C to gastroenterologists. Most PCPs (76%) were familiar with available hepatitis C testing guidelines. Conclusions Most PCPs test for HCV infection appropriately, but many do not elicit risk factor histories that could identify such persons. More effective training with emphasis on eliciting a history of pertinent risk factors is needed.