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Form Download

Form Download


HIV EIS Forms
     Consent Form  –  Sample

     Field Report Form  -  due each quarter

     OraSure Request Form
 

HIV Test Report
     Manual

     Sample Form

     Tip Sheet by Judi Duffy


Rapid HIV Testing
     Clearview Request Form

     CLIA Waiver - Application & Instructions

     CLIA Waiver Application - Where to Send


     Control Pack Log

     Georgia HIV and STD Laws


     HIV Test Result Log

     Policy, Procedures, and Quality Assurance Plan - Template


     Refrigerator Temperature Log

     Supplies & Equipment


     Thermometer - Minimum, Maximum


Temporary HIV Test Reports - In case of shortage
     Form Template










     

   Links to Resources:

Events:

Use the momentum of national and global HIV/AIDS events to engage your community. Learn more


Forms:

Want a CLIA Waiver? Need rapid HIV testing P&P? Click here

Caution: This website contains HIV/AIDS-related messages that may be considered controversial by some viewers.


The HIV Early Intervention Services Program
is made possible by Federal Substance Abuse Prevention and Treatment Block Grant funds
set aside for the delivery of early intervention services for HIV.

HIV Early Intervention Services is a program of The Office of Addictive Diseases
Georgia Department of Human Resources
Division of Mental Health/Developmental Disabilities/Addictive Diseases

Coordination of the Georgia HIV EIS program is provided by Imagine Hope, Inc.