Home
    

Form Download

 

 

HIV TESTING

 

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

 

Supplies

           

          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

 

 

Reporting

 

          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

 

         Amend Your CLIA Waiver (to include rapid HCV testing)


         CLIA Waiver Amendment APPLICATION

 

         Quality Assurance Guidelines Template

 

         HCV & HIV Consent Form

 

         HCV Control Log

 

         HCV Rapid Test Result Log

    

         HCV Blood Drawn Test Result Log

 


Supplies, Lab Instructions

 

         OraQuick Request Form

    

         Lab Instructions - RNA Test to Confirm Rapid Ab+

 

         Lab Instructions - BLOOD DRAWN Ab testing
       

 

Reporting

 

         Monthly Recap

 

         Quarterly Report Quick Tips

 

         Quarterly Report

 

         SendSS - How to

 

 

Testing & Linkage Forms

 

         360 Release Form

 

         Risk Assesment Form - 2017

 

         Staying in Touch Form

 

 

Quality Assurance

 

         HCV QA Guidelines Template

 

         HCV & HIV Consent Form

 

         HCV Control Log

 

         HCV Rapid Test Result Log

 

         HCV Blood Drawn Test Result Log

 

        
Quality Assurance REVIEW

          Rapid HCV Test Customer Letter

 

          Rapid HCV Test OPEN BOOK TEST

 

          Rapid HCV Test PROFICIENCY PANEL