prevention-point
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SEP enrollment object
Add non-participant fields from the SEP registration form to an SEP enrollment object in the back end
- What zip code do you live in or spend the most time in (5 digit varchar)
- Housing: □ Permanently Housed □ Temporarily Housed □ Shelter □ Street □ At Risk for Homelessness
- What drug do you inject most often? □Heroin only □Heroin and cocaine □Cocaine only □Fentanyl □Crack □Amphetamines, Speed, Crystal Meth, Ice □Hormones □Steroids □Silicone □ Botox □Other:____________ □Do not Inject (it'd be best if this is it's own object similar to
sites
, which is documented in #491) - Are you in drug treatment? □Yes □No
- If yes, is it: □Methadone □Suboxone □Vivitrol □IOP □Recovery House
- Do you have health insurance? □Medicare □Medicaid □No □Other:___________
- Have you ever been tested for Hepatitis C? ___________
- If so, when? ___________________
- Have you ever been tested for HIV? ___________
- If so, when? ___________________
- Do you have Narcan today? □Yes □No
FOR STAFF ONLY: □ Participant Received Harm Reduction Counseling □ Participant left with Narcan □ Participant Received Overdose Prevention Counseling □ Participant left with mobile site schedule □ Participant was referred to HIV/HCV testing