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Questions

Concepts

Contact Date

␣␣-␣␣-␣␣␣␣ 📆

Contact Method

🔘 Physical contact/client tracing

🔘 Telephone contact/client tracing

🔘 Other non-coded

Contacted Successfully

🔘 Yes

🔘 No

🔘 Unknown

Outcome

🔘 Contact came for HTS

🔘 Contact will test elsewhere

🔘 Refused Test

🔘 Partner confirmed HIV+

Contact booked for HIV test

🔘 Yes

🔘 No

🔘 Unknown

Date booked for HIV test

␣␣-␣␣-␣␣␣␣ 📆

Contact Tested for HIV

🔘 Yes

🔘 No

🔘 Unknown

Contact HIV Status

🔘 Positive

🔘 Negative

🔘 Indeterminate

🔘 Unknown

Outcome

Final Outcome reached (After successful or multiple unsuccessful tracing attempts)

🔘 Yes

🔘 No

Final outcome contact tracking

🔘 Partner HIV tested

🔘 Partner confirmed HIV+

🔘 Will test elsewhere

🔘 Contact is far from this facility

🔘 Contact unwilling to come

🔘 Dead

🔘 Unsuccessful

Notes

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