2018 screenshots

Att 3A 2018 version NHME_EvaluationWeb screen shots.docx

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0696 can be found here:

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Agency information:

Client information: Local Client ID# is not reported to CDC.

HIV test information:

Negative test result

Positive test result

Additional test information

PrEP

Essential Support Services

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Carolyn Wright
File Modified	0000-00-00
File Created	2021-01-20