Microbicide Trials Network

MTN-034/IPM 045 Study Implementation Materials

Counseling Tools/Worksheets
Adherence Counseling Worksheet2017-Oct-1371 KB
Adherence Goals Worksheet2017-Oct-1650.58 KB
Adherence Support Menu2017-Oct-16672.29 KB
Confidence Ruler2017-Oct-16157.76 KB
Contraceptive Counseling Worksheet2017-Jul-1253.5 KB
Daily Planner Worksheet2017-Oct-1672.81 KB
Enrollment Visit - PrEP2017-Oct-1342.69 KB
Enrollment Visit - Ring2017-Oct-1338.32 KB
Expectations Handout2017-Oct-16262.17 KB
Follow-Up Session - PrEP - no drug levels2017-Oct-1332.91 KB
Follow-Up Session - PrEP - with drug levels2017-Oct-13155.54 KB
Follow-Up Session - Ring - no drug levels2017-Oct-1333.02 KB
Follow-Up Session - Ring - with drug levels2017-Oct-13142.44 KB
HIV and STI Counseling Worksheet2017-Jul-1261 KB
REACH Sample Pregnancy Management Worksheet2017-Jul-3192 KB
Wireless drug level handout2017-Oct-16110.64 KB
CRFs/Data Collection
MTN-034 DRAFT Case Report Forms for IRB Submissions2017-Jul-181.1 MB
SCHARP Data Request Form2017-Jul-18100.21 KB
Eligibility Tools
Eligibility Checklist2017-Jul-0342.08 KB
Enrollment Behavioral Eligibility Worksheet – ENGLISH2017-Jul-1230.04 KB
Screening and Enrollment Log2017-Jul-1230.66 KB
Screening Behavioral Eligibility Worksheet - ENGLISH2017-Jul-1232.02 KB
IC Support/ Factsheets/ Education
Convo Cards2017-Oct-123.05 MB
Factsheet - One page2017-Oct-10413.5 KB
Factsheet Overview Booklet2017-Oct-10562.28 KB
IC Comprehension Assessment Template– ENGLISH2017-May-1636.35 KB
IC Coversheet Template2017-Jul-1229.51 KB
Informed Consent Flipchart2017-Oct-127.16 MB
Ring Poster2017-Oct-161022.6 KB
Tablet Poster2017-Oct-164.71 MB
Talking Points2017-Oct-12568.86 KB
Fun Images - High Resolution2017-Oct-1251.93 MB
Regulatory/FD Documents
DoA Log Template2017-Jul-12104 KB
Financial Disclosure Form2015-Aug-1825.08 KB
Financial Disclosure Form for Protocol Chair2015-Aug-1824.79 KB
Financial Disclosure Form Training Slides2017-Feb-27924.23 KB
Meeting Report: Stakeholders consultation on REACH (MTN-034) 2016-Sep-293.34 MB
Safety/ Clinical/Product Use Management
Baseline Medical History Questions Sheet2017-Aug-1044.05 KB
Product Use Management Flow Sheets2017-Jul-12104.99 KB
Protocol Safety Review Team (PSRT) Query Form2017-Aug-2241.46 KB
Ring Use Instructions2017-Oct-10482.24 KB
Safety Lab and Creatinine Clearance Calculator2017-Jul-1254.79 KB
Self-Collected Vaginal Swab Instructions2017-Jul-12428.96 KB
Tablet Use Instructions2017-Oct-10522.63 KB
SOP Templates
Clinic Product Accountability SOP2017-Jun-2949.34 KB
Clinic Study Product Destruction Log2017-Jul-0321.02 KB
Participant-Specific Clinic Study Product Accountability Log2017-Jul-0323.41 KB