Medium

Available on

Apple Android Windows

STD Risk Assessment Evaluation Mobile App

STD Risk Assessment Evaluation mobile app is a health risk assessment std prevention and risk reduction. This application will ask questions to know about sexually transmitted diseases symptoms like HIV, aids, herpes, chlamydia, and gonorrhea. It uses checkbox fields, multi-line comments, drop down menu and a signature field. The health risk assessment is a great app for anyone who works in std prevention, HIV prevention, and std HIV education programs.

  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

Want to learn more about GoCanvas?

Request a Demo

Take a peek inside the STD Risk Assessment Evaluation Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date of visit

  • Ico date

    Date of Birth

  • Ico integer

    Age

  • Ico textbox

    Last Name

  • Ico textbox

    First

  • Ico textbox

    M

  • Ico dropdown

    Sex

  • Ico textbox

    Marriage Status

  • Ico dropdown

    Race/Ethnicity

  • Ico dropdown

    ASYMPTOMATIC

  • Ico multiline

    STD SYPMTOMS PRESENT TYPE and LOCATION

  • Ico dropdown

    LESION

  • Ico textbox

    LOCATION

  • Ico dropdown

    RASH

  • Ico textbox

    LOCATION

  • Ico dropdown

    DISHCHARGE

  • Ico textbox

    LOCATION

  • Ico dropdown

    PAIN

  • Ico textbox

    LOCATION

  • Ico multiline

    OTHER (DESCRIBE)

  • Ico multiline

    Are you currently taking any medications

  • Ico multiline

    Do you have and medication allergies

  • Ico checkbox

    EXCHANGE DRUGS/MONEY FOR SEX

  • Ico checkbox

    EXCHANGE SEX FOR DRUGS OR MONEY

  • Ico dropdown

    SEX WITH

  • Ico checkbox

    IV DRUG USE PAST YEAR

  • Ico checkbox

    IV DRUG USE SINCE 1977

  • Ico checkbox

    SEX WITH A HIV POSITIVE PARTNER

  • ...and More!

Related Health Care & Social Services Apps... and they're all free for GoCanvas subscribers!

App Name

Medical History Form - Motorola Solut...

This app requests all information concerning the past of a patient's medical needs. It checks past and current health issu...

App Name

Development of Sanitation Program: Fr...

Fruits and vegetables are often eaten without cooking or further preparation and because of this they require extra cautio...

App Name

LVN On Call Communication Protocols: ...

The LVN On Call Communication Protocols: Genitourinary Conditions mobile app is an easy to follow Genitourinary Condition...

App Name

Pest Inspection Sanitation Report

Our Pest Inspection Sanitation Report mobile app is an easy-to-use app for anyone who needs to document required sanitatio...

App Name

Child Health Assessment - Infancy 6 M...

Assess the subject’s overall health using objective measure as well as subjective measures using a set of carefully crafte...

App Name

Dental Insurance Information Form

Why make your staff re-enter the same dental plan information your patients just wrote on your paper forms, when the pat...

App Name

Managing Chronic Non-Terminal Pain: O...

The Managing Chronic Non-Terminal Pain: Outline for Initial Evaluation of Chronic Pain mobile app provides procedures for ...

App Name

General Workplace Induction on Starti...

Use this mobile app as a guideline for conducting a general health and safety induction for all young workers, whether th...

More Information