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Check Your Eligibility
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HIV Status
Sexual History
Previous Medical Conditions
Preferred Contact details
Have you been Diagnosed with HIV before?
PrEP is not available if you have already been diagnosed with HIV
X
Yes
No
Have you had penetrative sex in the past 6 months
Anal or Vaginal
Yes
No
How many partners have you had penetrative sex in the past 6 months
In the past 6 months
0-5
6-10
10+
How many times have you had condomless penetrative sex in the past 6 months
in the past 6 months
0
1+
Been diagnosed with any of the following
Please select any condition you've been diagnosed with:
Hepatitis B
Hepatitis C
Diabetes
Liver Disease
Kidney Disease
Do you take any medications regularly
Yes
No
Do you have any drug allergies
Yes
No
Do you have any medical conditions or anything we should know about your medical history
Yes
No
How would You like Your Consultation
How much do you expect to use each month?
Phonecall
Through a form
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