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Get Luther Consulting HIV Test Template EvaluationWeb 2018

Client County (3-digit FIPS code) PS15-1506 PrIDE Client ZIP Code PS15-1509 THRIVE PS19-1901 CDC STD PS17-1711 Other CDC funded PS18-1802 Other non-CDC funded Client Ethnicity Hispanic or Latino Not Hispanic or Latino Specify Other (optional) Client Race (select all that apply) American Indian/Alaska Native Asian Black/African American Native Hawaiian/Pacific Islander Agency Name or ID Site Name or ID Don t know Declined to Answer White Not Specified Declined to Answer Don t K.

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