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Get Samhsa Mai Rapid Hiv/hepatitis Testing Clinical Information Form 2018-2025
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How to fill out the SAMHSA MAI Rapid HIV/HEPATITIS Testing Clinical Information Form online
This guide provides a step-by-step approach to effectively complete the SAMHSA MAI Rapid HIV/HEPATITIS Testing Clinical Information Form online. Follow these instructions to ensure accuracy and comprehensiveness in your submission.
Follow the steps to fill out the form correctly.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by filling in Section A. Enter the date of visit in mm/dd/yyyy format, followed by your grantee number, partner ID if applicable, CLIENT RHHT ID, and GPRA ID. Indicate if the GPRA Tool was not completed and select the site type code from the available options.
- In the next portion, provide the Rapid HIV test kit lot number.
- Proceed to Section B to fill out the demographics. Select the appropriate options for gender, age, and race, ensuring to check the correct ethnicity and confirm if the user has previously tested for HIV or Viral Hepatitis.
- In Section C, answer questions about risk behaviors. Check all applicable boxes detailing the user's actions regarding unprotected sex and substance use over the past 30 days.
- Next, complete Section D with the results of the Rapid HIV Test, confirming whether the user has received results and indicating retest results if necessary.
- If relevant, fill out Section E for Rapid Hepatitis B & C testing results. Follow similar steps as in Section D, ensuring to indicate whether the user received the results.
- For users with a positive Rapid HIV test result, complete Section F regarding confirmatory testing results. Similarly, Section G addresses confirmatory testing for Hepatitis B & C if applicable.
- Finally, in Sections H and I, indicate the types of services provided, including various counseling and testing options. Review the information for accuracy.
- After completing all sections, save any changes made to the form, and consider downloading, printing, or sharing the completed document as needed.
Complete your documents online today to ensure your information is accurately processed.
Yes, a rapid HIV test can detect the presence of HIV in your body. These tests typically provide results within 20 minutes, allowing for quick access to your health information. By using the SAMHSA MAI Rapid HIV/HEPATITIS Testing Clinical Information Form, you can ensure that you are accessing reliable testing methods tailored to your situation.
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