Paperwork

On this page, you will find common pieces of paperwork that we may ask patients to fill out before their appointments.

Gilead Assistance For PrEP Patients Without Insurance (fill out Sections 1-6, as instructed on page 1, sign anywhere it indicates patient signature, and bring to your first appointment with valid proof of income( last 2 pay stubs, W2, completed income taxes, etc.)

Release of Information (used to give a.l.p.h.a. permission to release records or results to another doctor’s office, and individual, or any other entity you might want to have your testing results)

New Patient Paperwork