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Service Delivery Model Form✅
Questions | Concepts |
---|---|
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 __________________________________ |