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Know The Facts
HIV/AIDS
Sexually Transmitted Diseases (STDs)
PrEP/nPEP
Living With HIV
Statistics
Resources
Get Tested
Get Treated
Condoms
FAQs
Become A Partner
Condom Ordering Form
Condom Locations
Get Free Condoms
Female FC2 Condom
Resources
HIV Prevention
Request Our Services
HIV/AIDS 101 Video
Community Services
National HIV/AIDS Awareness Days
Community Initiatives
Providers Corner
Submit An Event
Counseling, Testing & Linkage (CTL)
Trainings
Calendar
HIVAIDS 501 UPDATE Pre-Registration Form
TRAINING DATE & TIME REQUESTED (Seleccione la fecha y hora del curso):
*
August 21, 2019 - 10:00 AM
August 30, 2019 - 1:00 PM (*DOH Internal Only) - West Perrine
September 25, 2019 - 10:00 AM
October 4, 2019 - 1:00 PM (*DOH Internal Only) - Health District Center
October 9, 2019 - 10:00 AM
November 20, 2019 - 10:00 AM
TESTING SITE INFORMATION (Datos de la institución donde se efectúa la prueba)
Name of Agency (Nombre de la Agencia):
*
Site Number (Código [#] de la Agencia):
PARTICIPANT INFORMATION (Datos del solicitante)
Name (Nombre completo):
*
CTL ID # (Número de Identificación de Consejería, Prueba y Vinculación al Cuidado de Salud):
Email Address (Dirección electrónica):
*
Phone Number (Teléfono):
*
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