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STI self-collection & mail-order tests
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1. What STI and HIV self-collection and mail-order test company do you represent?
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Testing
2. What do you test for? (Check all the apply.)
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3. What is the cost per test kit?
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4. Do you accept insurance?
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5. What collection/anatomical sites does your test swab?
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6. What sample/specimen is collected?
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Do you provide instructions or information in different languages? If so, what language(s)?
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7. Do you send reminder(s) for sample collection?
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7a. If yes, via what avenues? (Check all that apply)
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Reminders
8. Do you send reminder(s) for sending
back the kit?
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8a. If yes, via what avenues? (Check all that apply)
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Lab
9. Is the laboratory in-house or are specimens sent to an outside/contracted lab?
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Portal
10. When are results uploaded to the portal or available to the patient/LHD (i.e., 2-5 days)?
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11. Who can receive results?
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12. Do you follow up or provide guidance to patients who test results are reactive or positive?
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12a. If yes, do you offer telehealth or virtual clinical consultation?
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Follow-up
13. Are self-collect instructions available upon kit activation?
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Training
14. Do you provide training or any onboarding offerings for new users interfacing with your platform?
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15. Are clinicians/providers (e.g., nurses, physician assistant or medical doctors) available through your platform to address user/patient's questions or concerns?
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16. Do you offer medication?
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17. What medication options are available to the patient?
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18. What is the cost for mail-order medication?
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19. Do you offer partner services? According to the CDC, an important part of Partner Services is partner notification, a process through which infected persons are interviewed to elicit information about their partners, who can then be confidentially notified of their possible exposure or potential risk.
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20. Do you have any partnerships with local health departments (LHDs) or community-based organizations (CBOs)?
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20a. If yes, please share the LHDs and CBOs that you are partnered with?
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System Integration
21. Does your platform have the ability to integrate with public health Electronic Health Records (EHR) and surveillance systems?
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21a. If yes, which EHR systems?
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POC
22. Are you willing to contract with an LHD?
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23. Are you an affiliate business partner with NACCHO?
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24. Who is your point-of-contact for LHDs to contact for procurement or partnership opportunities?
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25. Any comments?
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