CLINIC SCORE CARD
登录 Google 即可保存进度。了解详情
DATE:           *
FACILITY:         *
LOCATION: *
HEALTHCARE PROVIDER:   *
1. This facility has warm and friendly staff. *
2. The staff in this facility are knowledgeable on LGBTQI & MSM needs. *
3. LGBTQI & MSM health care tools are available. *
4. I can access PrEP here. *
5. I can access PEP here. *
6. Condoms and lubricants are available. *
7. Finger cots and dental dams are available. *
8. Gender Affirming Hormone Therapy / HRT is available here. *
9. ARV’s are available here *
10. I would recommend this facility. *
提交
清除表单内容
切勿通过 Google 表单提交密码。
此内容不是由 Google 所创建,Google 不对其作任何担保。 举报滥用行为 - 服务条款 - 隐私权政策