Please use this form to request someone to contact you regarding a free, confidential HIV test and discuss the best option (in-clinic or at home testing) for you.

This service is limited to our 10-county service area (Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe and Walton counties).

A member of our staff will reach out to you via phone or email for the next step.

HIV Test Request
Please enter your full name - First and Last
Please be sure to enter a phone number OR an email address in order for us to contact you.
Please be sure to enter a phone number OR an email address in order for us to contact you.
This service is limited to our 10-county service area at this time.
How did you hear about us?
Last Updated on June 29, 2023