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Hey Chuck I have been HIV for 12 yrs and on Atripla for about the same, it would be nice to talk to someone with something in common.
I am 99% sure that I signed a similar form in Allen County, Indiana at the time that I registered as client of the AIDS Task Force in Fort Wayne.
I signed a form at the Coventry Teaching Primary Care Trust, UK. The Dr. told me it was a requirement for a full health check up, that was in 2005. After I tested HIV+, the Counselor told me that even if I was crying, I should have known that I was most likely HIV+, when I asked her, how, she told me that sometimes you just know these things. To date, I keep wondering why I never met her before the test.
Martin County, in South Florida has such a form and I was required to sign it upon learning that I was HIV positive.
I know that Sweden requires the newly diagnosed hiv client to sign such a form. Contact: ombudsman@hiv-sverige.se for verification. Norway has no such requirements.
I was forced to sign a form detailing ALL of that information. It was in Spartanburg County, South Carolina... at a HIV facility called "Piedmont Care."
I learned I was poz in February 2010. I remember being visited by a health department employee with a form she said was required by the city of San Antonio, Texas or Bexar County health department. I don't remember which. I didn't sign the form. She said my doctor should have told me that I would be contacted. Hope this helps.
j in bako
Hi Sean, I DO know of a county that requires such a form, in order for you to receive benefits through what was once known a their EIP (Early Intervention Program). How do I get this information to you? I looked for a 'Contact Us' link but was unable to find it. Please forward some means of contact to my email address. Thanks! I look forward to hearing from you...and keep up the GREAT WORK! God bless! J
October 2, 2010