S/N | Description | Qty | | |
| |
1 | Combined Pharmacy Order Form – Triplicate, A4, Soft Bond, Soft Cover | 600 | | |
2 | Viral Load Order and Result Form – Duplicate, A4, Soft Bond, Soft Cover | 600 | | |
3 | Adult Initial Clinical Evaluation Form – A4, Duplicate, Softcover, Soft bond | 300 | | |
4 | HIV Patient Tracking Register – A3, Bond paper, Hardcover, Hard bond | 200 | | |
5 | Pharmacy Daily Worksheet – A3, Bond paper, Hardcover, Hard bond | 100 | | |
6 | Appointment Book – Bond paper, A4, Spiral Bond, Hard Cover | 200 | | |
7 | Facility DSD Register – A3, Bond paper, Hardcover, Hard bond | 100 | | |
8 | HIV Care and Treatment Transfer Form | 100 | | |
9 | Viral Load Monitoring Register – A3, Bond paper, Hardcover, Hard bond | 100 | | |
10 | Enhanced Adherence Counselling Form – A4, Soft Bond, Soft Cover | 100 | | |
11 | Enhanced Adherence Counselling Monitoring Register – A3, Bond paper, Hardcover, Hard bond | 50 | | |
12 | Advanced HIV Disease Intensive Patient Follow-up – A4, Soft Bond, Soft Cover | 100 | | |
13 | Client Tracking & Discontinuation Form – Duplicate, A4, Soft Bond, Soft Cover | 100 | | |
14 | Operation Triple Zero Register – A3, Bond paper, Hardcover, Hard bond | 200 | | |
15 | OTZ peer champion Module – A4, Soft Bond, Soft Cover | 200 | | |
16 | Checklist for follow-up of HIV infected Adolescent – A4, Soft Bond, Soft Cover | 200 | | |
17 | Operation Triple Zero Service Form – A4, Soft Bond, Soft Cover | 200 | | |
18 | OTZ Individualized Treatment assessment plan 1 of 2 and 2 of 2 – A4, Soft Bond, Soft Cover | 200 | | |
19 | Referral Forms – Bond paper, A4, Hard Bond, Soft Cover | 100 | | |
20 | Client Intake Form – Bond paper, A4, Hard Bond, Soft Cover | 300 | | |
21 | HIV Testing Services Register – Bond paper, A3, Hard Bond, Hard Cover | 100 | | |
22 | Partner Notification Service Form – A4, Soft Bond, Soft Cover | 100 | | |
23 | Index Testing Register – Bond paper, A3, Hard Bond, Hard Cover | 100 | | |
24 | PrEP Register – Bond paper, A3, Hard Bond, Hard Cover | 200 | | |
25 | Family Index Testing Form – Bond paper, A4, Hard Bond, Soft Cover | 50 | | |
26 | HIV Self-Testing Register – Bond paper, A3, Hard Bond, Hard Cover | 50 | | |
27 | HIV Self–Test Response and Referral Card – A3, Card printed front and back | 300 | | |
28 | PMTCT HTS Register – Bond paper, A3, Hard Bond, Hard Cover | 50 | | |
29 | Child Follow-up Register – Bond paper, A3, Hard Bond, Hard Cover | 20 | | |
30 | Maternal Cohort Register – Bond paper, A3, Hard Bond, Hard Cover | 20 | | |
31 | Cervical Screening and Treatment Register – Bond paper, A3, Hard Bond, Hard Cover | 200 | | |
32 | Cervical Cancer Screening Referral Card – A4 Booklet, Bond Paper, Soft Bond | 200 | | |
33 | Cervical Cancer Screening and Treatment Referral Tracker – A4 Booklet, Bond Paper, Soft Bond | 200 | | |
34 | Cervical Cancer Screening Form – Bond paper, A4, Hard Bond, Soft Cover | 200 | | |
35 | IPT Screening Tool | 120 | | |
36 | PLHIV Presumptive TB diagnosis evaluation and treatment register. | 200 | | |
37 | National Gender Based Violence (GBV) Service Delivery form 1 of 2 and 2 of 2 – A4, Soft Bond, Soft Cover | 600 | | |
38 | National Gender Based Violence (GBV) Incidence Form 1 of 2 and 2 of 2 – A4, Soft Bond, Soft Cover | 600 | | |
39 | National Gender Based Violence (GBV) Care Register – A3, Bond paper, Hardcover, Hard bond | 400 | | |
40 | Gender-Based Violence (GBV) Routine Enquiry Tool – Bond paper, A4, Hard Bond, Soft Cover | 600 | | |
41 | Gender-Based Violence (GBV) Routine Enquiry Tool (Treatment Support) – Bond paper, A4, Hard Bond, Soft Cover | 600 | | |
42 | Gender – GBV Training LOG – A4, Card printed in the front | 364 | | |
43 | Gender – GBV Prevention / Outreach Log – A4, Card printed on the front | 364 | | |
44 | Gender – GBV Monthly Reporting Summary: Referrals | 200 | | |
45 | Follow-Up Patient Form: PEP and POST PEP HIV TEST – A4, Bond paper, Soft Cover, Soft Bond | 384 | | |
46 | National Gender Based Violence (GBV) Client Screening and Intake form – A4, Bond paper, Soft Cover, Soft Bond | 600 | | |
47 | Household Vulnerability Assessment Form – 100 sheets, A4, Bond paper, soft cover, soft bond | 800 | | |
48 | Nutrition assessment form – 100 sheets, A4, Bond paper, soft cover, soft bond | 800 | | |
49 | Care Plan Achievement Checklist – 100 sheets, A4, Bond paper, soft cover, soft bond | 700 | | |
50 | Referral form for Vulnerable Household – Triplicate, A4, Soft Bond, Soft Cover | 400 | | |
51 | Vulnerable Children Enrolment Form – 100 sheets, A4, Bond paper, soft cover, soft bond | 800 | | |
52 | Care Giver Access to Emergency Fund – 100 sheets, A4, Bond paper, soft cover, soft bond | 700 | | |