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Documents/Forms/Educational Tools

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 TitleDescriptionCategoryModified Date 
Medical HistorySample prenatal medical history, includes HIV/STDClinical11/21/2011Download
Intrapartum Management of all HIV positive women.Sample policy and procedure written at Desoto Memorial Hospital.Clinical11/21/2011Download
Sample Hospital Orders for HIV Exposed NewbornSample hospital orders for the HIV exposed newborn, includes AZT dosing, baseline labs, reporting and follow-up. May be modified as needed.Clinical11/21/2011Download
Prenatal Record Includes HIV TestingSample prenatal record that includes required third trimester HIV testingClinical4/13/2010Download
Sample - Treatment Neonatal HIV Exposed Newborn - Desoto Memorial HospitalSample policy and procedure for care of exposed newborn, Desoto Memorial Hospital.Clinical12/20/2010Download
Sample Policy & Procedure for Rapid Testing in Labor & DeliverySample policy for rapid testing in labor and delivery and reporting of exposed newborns. This policy and procedure is based on Florida law and can be modified to meet facility requirements.Clinical6/10/2010Download
Statement of Objection in Creole/DOHFlorida DOH statement of objection to HIV/STD testing in Hatian CreoleClinical4/13/2010Download
Statement of Objection in English/DOHFlorida DOH statement of objection to HIV/STD testing in EnglishClinical4/13/2010Download
Statement of Objection in Spanish/DOHFlorida DOH statement of objection to HIV/STD testing in SpanishClinical4/13/2010Download
Statement of Objection to HIV/STD Testing/GenericThis form includes information to assist patients with making an informed decision and asks them to acknowledge this.Clinical4/13/2010Download
Sample Rapid HIV Testing Policy - Desoto Memorial HospitalDesoto Memorial Hospital policy for care of women admitted to L&D with unknown/undocumented HIV status.Clinical12/20/2010Download
Map of Infected Infants 2005-2010Florida county map depicting where infected babies were born. Provided by FL DOH.Florida Statistics6/3/2011Download
Map of Exposed/Infected Births 2009Florida county map depicting where exposed and infected babies were born.Florida Statistics12/20/2010Download
Map of Exposed/Infected Births 2008Florida county map depicting where exposed and infected babies were born.Florida Statistics4/13/2010Download
FDA Approved Rapid HIV Screening Test ChartCurrent comparison chart of the FDA approved rapid HIV screening tests.For Your Information4/13/2010Download
Definitions of Commonly Used TermsA list of commonly used terms related to HIV and AIDSFor Your Information4/13/2010Download
Florida 64D-3FAC 64D-3. Updated and effective on 11/24/08. Changes in 64D-3.029 Diseases or Conditions to be Reported. HIV reporting exposed infants see page 10Laws4/13/2010Download
Florida 64D-3.042 STD Testing Related to PregnancyExcerpt of FAC 64D-3 specific to HIV/STD testing in pregnancy.Laws4/13/2010Download
Practitioner List of Reportable Diseases or Conditions in FloridaEasy to follow printable guide for your office or clinicReporting12/20/2010Download
Practitioner Reporting PacketHealth care practitioner reporting guidelines of notifiable diseases and conditions, revised November 24, 2008.Reporting4/13/2010Download
Practitioner Single Disease Reporting FormUsed to report the suspect or diagnosis of a disease which is reportable under F.A.C. 64D-3.Reporting12/20/2010Download
Florida HIV/AIDS Surveillance Contacts for Reporting CasesDetailed list includes surveillance area, counties, and direct contact informationReporting4/13/2010Download
HIV Testing in Health Care Settings: Implementing the CDC Recommendations for Routine Testing in Florida Educational tool to assist with implementing routine HIV testing in all Florida's health care settings.Slides12/20/2010Download
  

Perinatal Products - Order Here

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 TitleDescriptionCategoryModified Date
A PRODUCT ORDER FORMSimply fill it out, print, and fax it toll free to (866) 266-0505. Materials and shipping are free. Please include the quantity of each item you are requesting. 3/27/2012
Fè Tès VIH/MST Ka Sove Lavi Tibebe Yo (Creole)Professionally translated to Creole, this patient brochure is for use in the hospital or office, reinforces the importance of HIV/STD testing in pregnancy to prevent mother-to-infant transmission.Brochure4/21/2011
HIV/STD Testing can save your baby's life - EnglishPatient brochure for use in the hospital or office reinforces the importance of HIV/STD testing in pregnancy to prevent mother-to-infant transmission.Brochure5/24/2010
Los Exámenes de VIH/ETS Pueden Salvar la Vida de su Bebé (Spanish)Professionally translated to Spanish, this patient brochure is for use in hospital or office, reinforces the importance of HIV/STD testing in pregnancy to prevent mother-to-infant transmission.Brochure4/21/2011
Pregnancy and HIV: What you need to know Patient education and plan of care for pregnancy, labor, delivery, and newborn follow-up care and testing. Space for Avery label #6572 to add nurse or care coordinator contact information.Patient Education4/21/2011
Embarazo Y VIH: Lo que usted debe saber (Spanish)Professionally translated patient education and plan of care for pregnancy, labor, delivery, and newborn follow-up care and testing. Space for Avery label #6572 to add nurse or care coordinator contact information.Patient Education-Spanish4/21/2011
Perinatal HIV Testing Law Poster - CreoleGlossy 16x20 poster, suitable for framing, patient education explains Florida's routine prenatal HIV/STD testing law in Haitian Creole.Poster5/18/2010
Perinatal HIV Testing Law Poster - EnglishGlossy 16x20 poster, suitable for framing, patient education explains Florida's routine prenatal HIV/STD testing law.Poster5/18/2010
Perinatal HIV Testing Law Poster - SpanishGlossy 16x20 poster, suitable for framing, patient education explains Florida's routine prenatal HIV/STD testing law in Spanish.Poster5/18/2010
Rapid Testing Flip Chart - CreoleSpiral bound flip chart to facilitate patient and provider education in the L&D unit. Specify either 4x5 or 9x11. When viewing, these files have 10 pages.Rapid Testing5/24/2010
Rapid Testing Flip Chart - EnglishThis educational tool is based on Florida HIV/STD testing lawsRapid Testing5/18/2010
Rapid Testing Flip Chart - SpanishContains the necessary information for patient to make an informed decision about HIV/STD testingRapid Testing5/18/2010
  
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