HIV Testing Informed Consent Form

Patient Information

Full Name Date of Birth Email Address Phone Number

Consent to HIV Testing

I have been informed about the HIV test and its purpose, as well as its possible risks, benefits, and alternatives. I understand the following:

The test is used to determine whether I have been infected with HIV.
Positive test results will be reported to appropriate public health authorities as required by law.
The meaning of positive and negative test results has been explained to me.
I may ask questions about the test at any time.
My decision to be tested is voluntary.

Consent

I give my informed consent to undergo HIV testing.

Questions or Comments

If you have any questions or comments, please indicate below:

Patient Signature Date

Witness Signature Date