Acrobat_forms

US-Mexico Border Health Evaluation and Technical Assistance Center

Adobe Acrobat Reader Forms
(for electronic submission of data)

Multi-site Evaluation		*English*	*Spanish*
A	Demographics	demographic.pdf	demográficos.pdf
B	Life-style & culture	lifestyle.pdf	estilo de vida.pdf
C	Change form	change.pdf	-
D	Risk factors	risk factors.pdf	factores de riesgo.pdf
E	Quality of life	quality of life.pdf	calidad de vida.pdf
F	Barriers to HIV/AIDS care	barriers.pdf	barreras.pdf
G	Client satisfaction	client satisfaction.pdf	satisfacción del cliente.pdf
Local Evaluation		*English*	*Spanish*
1	Social support	social support.pdf	apoyo social.pdf
2	Outreach demographics	outreach_demographics.pdf	-
3	Outreach contact	outreach_contact.pdf	-
4	Testing Demographics	testing demographics.pdf	pruebas demográficos.pdf
5	NMX Outreach Demographics	nmx outreach demographics.pdf	-
6	NMX Outreach Contacts	nmx outreach contacts.pdf	-
7	AETC Clinician Assessment	aetc clinician assessment.pdf	-
8	AETC Provider Assessment	aetc provider assessment.pdf	-
9	Hispanic Stress Inventory	hispanic stress inventory.pdf	estres hispanos
10	Health Services Scale	health services scale.pdf	-
11	CAL HIV Testing Results	cal hiv testing results.pdf	-
12	CAL Risk	cal risk.pdf	cal - factores de riesgo
13	NMX Risk	nmx risk.pdf	nmx - factores de riesgo

Must have Adobe Acrobat Reader program loaded on computer. Forms may be completed "on-line" and,

1. printed and mailed or faxed to Evaluation Center, or
2. submitted electronically via the internet**************