FORMS AND DOWNLOADS

All of the following forms require Adobe Acrobat Reader to open and print.  You may download the free Acrobat Reader by clicking HERE.

WYOMING CASE MANAGEMENT SITES:

  Case Management Sites  *NEW LIST* updated December 2011

HIV SERVICES PROGRAM (RYAN WHITE PART B/ADAP/HOPWA):

  2011 Application Form
  2011 Income Elegibility Guidelines
  Income Verification Form
  Provider's Medical Certification Form
  Veteran's Eligibility Verification Form
  Prior Authorization Request Form
  ADAP Formulary, last updated January 1, 2011
  Transportation Expense Verification Form
  Patient Rights and Responsibilities Form
  Patient Grievance Procedures Form
  Client Housing Plan

 
HIV/AIDS/HEPATITIS CARE AND PREVENTION PLANNING ALLIANCE (CAPPA):

  
   Membership Application Form
   CAPPA Bylaws    

HIV COUNSELING AND TESTING:

   MASTER CALENDAR:  SEE FOR ALL 2012 HIV RELATED EVENTS

~*~  As events are added, the calendar will be updated.  Please check back often. ~*~                           

  

HIV PREVENTION MATERIALS 

   2011 HIV Prevention Materials Ordering Form

 

HIV/HEPATITIS/STD CONTENT NOTICE:    This site may contain prevention messages that may not be appropriate for all audiences.  Since HIV, Hepatitis, and/or STD infections are spread primarily through sexual practices or by sharing needles, prevention messages and programs may address these topics.  If you are not seeking such information or may be offended by such materials, please exit this site. MEDICAL INFORMATION DISCLAIMER: All information contained on this web site, including information relating to health conditions, products, and treatments, is for informational and educational purposes only.  Although this web site may provide visitors with information to better understand their health and risk factors for specific diseases, the Wyoming Department of Health (WDH) does not intend to provide specific medical advice.  Any information presented is not meant to substitute for the advice provided by your own doctor or other medical professionals.  WDH and the HIV/AIDS/Hepatitis Program urge you to consult with a qualified health care provider for diagnosis, treatment, and answers to your personal health care questions.