Disclosure Form✅

Questions	Concepts
HIV disclosure detail	169481 HIV disclosure detail
Date of Disclosure ␣␣-␣␣-␣␣␣␣ 📆	160753 Date of event
Stage of disclosure 🔘 HIV Pre-disclosure 🔘 Partial disclosure 🔘 Full disclosure: Stage 1 🔘 Full disclosure: Stage 2 🔘 Full disclosure: Stage 3 🔘 Full disclosure: Stage 4	169422 Stage of HIV disclosure 169421 HIV pre-disclosure 169420 Partial HIV disclosure 169416 Full HIV disclosure, stage 1 169417 Full HIV disclosure, stage 2 169418 Full HIV disclosure, stage 3 169419 Full HIV disclosure, stage 4
Disclosure Notes __________________________________	161011 Free text comment