Get Annexure Bl: Linkage Form (in Triplicate)

This guide provides step-by-step instructions for completing the Annexure Bl: Linkage Form online. By following these directions, you can ensure that all required information is accurately provided for effective referrals.

Follow the steps to fill out the form accurately and efficiently.

1. Click the ‘Get Form’ button to access the Annexure Bl: Linkage Form and open it in your document editor.
2. Begin by filling out the details of the individual being referred. Include fields such as PID Number, Name, Age, Sex, Contact Number, and Category (using tick marks to indicate the appropriate category).
3. Provide the purpose of referral and the date of referral in the designated sections.
4. For each copy of the form, include the details of the staff referring the individual, including their Name, Designation, Contact Number, and Signature.
5. Indicate whether the individual has reached the referred facility by selecting ‘Yes’ or ‘No’ in the relevant section.
6. If the referral is to an SA-ICTC, specify whether the individual has been tested for HIV. Answer ‘Yes’ or ‘No’.
7. If the individual is referred to an ART center, indicate whether they have been registered at that facility.
8. Add any additional remarks as necessary in the remarks sections.
9. Finally, review the completed form for accuracy, save your changes, and choose to download, print, or share the form as needed.

Complete the Annexure Bl: Linkage Form online today for efficient processing.