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This following web page is intended for agencies providing HIV counseling and
testing services in San Francisco. Agencies with questions about CTL forms and templates, or if you would like a form to be added to this web page,
please contact Shelley Facente at (415) 554-9136 or at [email protected]
CTL Protocols, Procedures, and Continuous Quality Improvement Plan Templates:
Resources for agencies without existing protocols
Resources for current network agencies with existing protocols
Forms:
CTL Data Forms
- SF HIV CTL Paperwork Deadlines (Flow Chart)
- CTL Policy Regarding Past Due Data
- External Quality Control Log
- HIV Confidential Case Report
- Rapid Testing Monthly Summary Sheet
- Standard Testing Monthly Summary Sheet
- Medical Linkage Form
- Blank CIF for HIV6
- HCV/HIV Integration Project Form (Hep C half-sheet)
- DAPS Partner Information Form (Anonymous 3rd-Party Notification Form)
- CDAPS Form – Each form is pre-printed with a unique code, so these forms cannot be downloaded from this website. Instead, they must be ordered by contacting Alice Heimsoth at [email protected]
Policies and Procedures
- CTL Data Quality Assurance Guidelines
- CTL Policy Regarding Past Due Data
- Protocol for Confirming Results Following a Preliminary Positive Rapid Test (re HIV-2)
- Protocol for Transport of Confirmatory Blood Specimens (Presumptive Positive Samples)
- Interim San Francisco Algorithm for Oral Rapid HIV Testing
Positive Test Forms
- SF HIV CTL Paperwork Deadlines (Flow Chart)
- Blank CIF for HIV6
- HIV Confidential Case Report
- Medical Linkage Form
- DAPS Partner Information Form
Rapid Testing Materials
- Rapid Testing Program Implementation Checklist
- External Quality Control Log
- Rapid Testing Monthly Summary Sheet
- Medical Linkage Form
- Competency Assessment Test (CAT) Instructions and Checklist
- Rapid Testing Time Chart
- Suggested Scripts for Client Contact Following an Invalid Rapid Test
- The Oral Rapid Test: Frequently Asked Questions for Counselors
- Memo to CTL Coordinators Regarding the Release of OraQuick Advance Rapid Test
- Detailed Steps for OraQuick Advance Test Procedure Using Oral Fluid
- OraQuick Advance Rapid HIV-1/2 Antibody Test Oral Specimen Collection Dos and Don’ts
- Interim San Francisco Algorithm for Oral Rapid HIV Testing
Standard Testing Materials
RTA Study Forms and Materials
- Storage Control Temperature Log (for Stat-Pak, Uni-Gold, & OPENED xSera Controls)
- Storage Control Temperature Log (for UNOPENED xSera Controls [Refrigerator])
- Blank CAT – Stat-Pak
- Blank CAT – Uni-Gold
- Contacts for HIV Primary Care for Uninsured Clients
- Contacts for HIV Primary Care for Insured Clients (HMO/PPO/Medicare/Medical)
- East Bay Referral List
Micellaneous Forms
- Request for Data Reports
- HIV CTL Counselor Evaluation Form
- HCV/HIV Integration Project Form (Hep C half-sheet)
- DAPS Partner Information Form
- Additional Information Form
