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Get and Sign Evaluationweb 2018-2022 Form

Get and Sign Evaluationweb 2018-2022 Form

Use a hiv template form 2018 template to make your document workflow more streamlined.

Positive undifferentiated HIV-1 Negative HIV-2 Inconclusive Inconclusive Yes client obtained the result from another agency Is the client at risk for HIV infection optional Risk Not Known Not Assessed Was the client screened for PrEP eligibility Is the client eligible for PrEP referral Yes by CDC criteria Yes by local criteria or protocol Was the client given a referral to a PrEP provider to a PrEP provider Has the client ever had a positive HIV test Date of first positive result department for...
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