Forms

The generic forms below have been developed by the TRACE Initiative team to support the roll-out of recent HIV infection testing. They are intended to be downloaded, adapted, and utilized by stakeholders in various countries. For technical assistance in adapting the materials to suit specific context and needs, please visit Contact Us.

1. Participant Tally Sheet



Download

2. Informed Consent Form



Download

3a. Asante Data Capture Form – Site Level



Download

3b. Maxim Data Capture Form – Site Level



Download

3c. Recent HIV Infection Surveillance Register



Download

4. Laboratory Requisition Form



Download

5a. Specimen Tracking Log Health Facility



Download

5b. Specimen Tracking Log Lab



Download

6. Return of Results Tracking Log



Download

7. Return of Recency Results Post-Test Counseling Guide



Download

8. Understanding HIV and Recent Infection Information Sheet



Download

9. Adverse Events Tracking Register



Download

10. Example Participant Risk Questionnaire Interview Guide



Download

11. Readiness Checklist for TOT and Panel Preparation



Download

12a. CQI Monitoring Checklist



Download

12b. CQI Monitoring Checklist (Short Version)



Download

13a. TOT Pre- and Post-Training Assessment



Download

13b. TOT Pre- and Post-Training Assessment Answer Key



Download

14a. TOT Trainee Results Form – Asante



Download

14b. TOT Trainee Results Form – Maxim



Download

15. QC and TOT Panel Prep Reference Results Form



Download

16. RTRI Training and Panel Prep Supply List



Download

17a. RTRI QC Logbook

&

17b. RTRI QC Logbook Job Aid



Download Form

Download Job Aid

18. RTRI Proficiency Testing Results Form



Download