Questions | Concepts | Enrollment/Disenrollment filter question***|
|---|---|---|
Date enrolled to DSD ␣␣-␣␣-␣␣␣␣ 📆 | ||
Date disenrolled from DSD ␣␣-␣␣-␣␣␣␣ 📆 | ||
Reason for disenrolling from DSD __________________________________ | ||
Antiretroviral treatment refill model 🔘 Community medication distribution, healthcare worker led 🔘 Community medication distribution, peer led 🔘 Express pharmacy pickup without clinician visit 🔘 Facility group medication distribution 🔘 Standard pharmacy pickup following clinician visit | ||
Notes __________________________________ |
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