Form Download





Getting Started


          Getting Started


          CLIA Waiver Application

          CLIA Waiver Application - WHERE TO SEND


          HIV Criminal Laws by State

          HIV Consent, Counseling Laws by State

          Policy, Procedures, and Quality Assurance - TEMPLATE



Forms (See P&P above for additional forms)


         Rapid HIV Test CONTROL Log


         Rapid HIV TEST Result Log


         Test Kit Storage Temperature Log


         Control Storage Temperature Log




          Bubble Sheet (HIV Test Report) Request Form


          Bubble Sheet GUIDE


          HIV Test Kits - Request Form


          HIV Test Kits - Who to Contact for Supplies


          Lab Supplies & Equipment Needed





          4 HIV Test Report Forms - An Overview


          FIELD REPORT Form - Due Quarterly


          Case Report Form - for HIV+ Clients


          Case Report Form EXPLANATION


          Confidential HIV+ Client Served Form


          Public Health District HIV Coordinators



Quality Assurance REVIEW

          Rapid HIV Test Product Insert


          Rapid HIV Test Product Insert OPEN BOOK TEST


          Rapid HIV Test PROFICIENCY PANEL



Hepatitis C



Launching Rapid HCV Testing


         Getting Started


         Getting a CLIA Waiver for rapid HCV testing

         CLIA Waiver APPLICATION


         Quality Assurance Guidelines and Forms


         Quality Assurance Forms - Customized


               HCV Control Log


               HCV Control Storage Temperature Log


               HCV Test Kit Storage Temperature Log


               HCV Rapid Test Result Log


               HCV Blood Drawn Test Result Log



Supplies, Lab Instructions


         Lab Supplies & Equipment Needed      


         OraQuick Request Form


         Lab Instructions - RNA Test to Confirm Rapid Ab+


         Lab Instructions - BLOOD DRAWN Ab testing




         Monthly Recap


         Quarterly Report Quick Tips


         Quarterly Report


         SendSS - How to



Testing & Linkage Forms


         Consent Form


         360 Release Form


         Hep Talk - HCV Education


         Risk Assesment Form - 2018


         Staying in Touch Form


Quality Assurance REVIEW

          Rapid HCV Test Customer Letter


          Rapid HCV Test OPEN BOOK TEST


          Rapid HCV Test PROFICIENCY PANEL