Questions | Concepts |
|---|---|
Contact Date ␣␣-␣␣-␣␣␣␣ 📆 | 160753AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA |
Contact Method 🔘 Physical contact/client tracing 🔘 Telephone contact/client tracing 🔘 Other non-coded | 59c023dd-eed2-4b11-8c34-b88e9439db3c |
Contacted Successfully 🔘 Yes 🔘 No 🔘 Unknown | 911d08b4-b523-46e4-8b65-e6924e95d015 |
Reasons for missing an appointment 🔽 Client could not get an off from work/school 🔽 COVID-19 Restrictions 🔽 Exposure to COVID-19 🔽 Had enough medications 🔽 Felt better and stopped taking medication 🔽 Inpatient care or hospitalization 🔽 Patient forgot to attend appointment 🔽 Patient was seen in another health center 🔽 Traveling 🔽 Other | 76072178-3545-4eb4-b5d0-55f59134d46a |
Expected Return Date ␣␣-␣␣-␣␣␣␣ 📆 | |
Outcome | |
Final Tracing Outcome reached (After successful or multiple unsuccessful tracing attempts) 🔘 Yes 🔘 No | eeba884c-67fc-4f03-be2e-8dd3eb64ae10 |
Final tracing outcome - Patient 🔘 Dead (Create a Death Form) 🔘 Undocumented/Silent transfer-out (Create a Transfer-Out Form) 🔘 Refused (stopped) treatment (Update ART Therapy Form) 🔘 Interruption in Treatment (Lost to follow-up) 🔘 Currently taking ARV | bc45edbd-11e7-4888-ad7d-4ec3dd8cdcf6 |
Notes __________________________________ | 165095AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA |
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