HIV/AIDS 501 Training Online Registration Form - Florida Department of Health in Escambia County

Florida Department of Health in Escambia County
HIV/AIDS Program Office

AIDS-501 Registration

The courses below are designed for volunteers and staff of DOH-approved HIV test sites only. Before staff can perform HIV counseling and testing services, they must successfully complete the initial HIV/AIDS 501 training. Registration is required at least two weeks in advance of the class, and the maximum number of participants per class is ten.

Before taking the HIV/AIDS 501 course, one must complete the prerequisite HIV/AIDS 500 course in TRAIN. Go to Train.org, set up an account, type in the search bar “AIDS 500 Course”, then click on the following: FDOH HIV/AIDS 500 The Basics of HIV/AIDS Counseling, Testing, and Linkage. Once you complete the training, print your certificate and bring it with you to class.

In order to ensure that each participant is registered for the training and receives confirmation, please provide the following information for our records, and complete the online form below.

HIV 500 Participant Agreement

HIV 501 Update Training Online Registration Form

URL

This field is for validation purposes and should be left unchanged.

Name of Participant(Required)

First Last

Participant E-mail Address(Required)

Participant Phone Number(Required)

Testing Site and Agency Number(Required)

Testing Site Manager Name(Required)

Testing Agency Address(Required)

Testing Agency City and Zip Code(Required)

Testing Agency Telephone Number*

Explain why you need to take this training

Florida Department of Health in Escambia CountyHIV/AIDS Program Office

HIV 501 Update Training Online Registration Form

Florida Department of Health in Escambia County
HIV/AIDS Program Office