Initiative Data Collection Forms | USF Health

Evaluation & Technical Assistance Center (ETAC)

Initiative Data Collection Forms

USF ETAC Hepatitis C Treatment Expansion Initiative Data Collection Forms & Data Portal

Click here to access the USF ETAC Data Center.

For instructions on how to use the Data Center please read the USF ETAC HSC/HIV Data Website manual.

Click here to download the manual

HIV/HCV Co-infected Population Patient Treatment Information Forms

Clinic Baseline Information
PDF | Word
Form A: Clinic Wide Information
PDF | Word
Form B: Pre-treatment
PDF | Word
Form C: Week 12
PDF | Word

Form D: Week 24
PDF | Word
Form E: End of Treatment
PDF | Word
Form F: Post Treatment
PDF | Word

For further assistance, please contact Sean McIntosh, Data Manager for USF ETAC.