ChiCAS Appointment Card - English

Att 10a_ChiCAS Appointment Card English.docx

HIV prevention among Latina transgender women who have sex with men: Evaluation of a locally developed intervention

ChiCAS Appointment Card - English

OMB: 0920-1266

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Attachment 10a


ChiCAS Appointment Card English



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If you can’t attend, call or text Lucero Refugio Aviles:

 

(336) 339-0349

 

 

Name: _________________

 

Date: _____/_____/_____

 

Time: _____

 

____________________________

 

 


Shape8 Shape7

 

If you can’t attend, call or text Lucero Refugio Aviles:

 

(336) 339-0349



 

 

Name: _________________

 

Date: _____/_____/_____

 

Time: _____

 

 

____________________________

 

 


Shape9


Shape11 Shape10

 

If you can’t attend, call or text Lucero Refugio Aviles:

 

(336) 339-0349



 

 

Name: _________________

 

Date: _____/_____/_____

 

Time: _____

 

 

____________________________

 

 



Shape13 Shape12

 

If you can’t attend, call or text Lucero Refugio Aviles:

 

(336) 339-0349



 

 

Name: _________________

 

Date: _____/_____/_____

 

Time: _____

 

 

____________________________

 

 


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(Fry &Flesch-Kincaid Readability: grade=6)

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorCindy Miller/PHS
File Modified0000-00-00
File Created2021-06-25

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