Last Updated: 04/19/2023
HIV Prevention Portal: Forms
Form Instructions and Due Dates:
- Click on the form's link.
- “Save” or “Save As” to your computer.
- Email completed forms to firstname.lastname@example.org
- HIV Prevention Programs Checklist, 2023-2024 (PDF)
A printable list of due dates for all required documents.
- HIV Prevention Grant Manager Contact List (PDF)
Use this list to locate contact information for your grant manager for all MDH-funded HIV prevention grants. All communications should be directed to your grant manager.
- EIS HIV Testing Progress Report (Word)
- Syringe Services Program Progress Report (Word)
- PrEP Progress Report (Word)
- EIS HIV Testing Program Work Plan (Word)
- Syringe Services Program Work Plan (Word)
- PrEP Work Plan (Word)
- Budget forms (Word)
Includes budget justification and instructions, budget summary, and indirect cost questionnaire.
- For a new invoice form template, please email request to email@example.com.
- For Direct Deposit: Minnesota Supplier Portal (PDF)
- Client Consent - Template (Word)
- Health Information Release - Template (Word)
- HIV/AIDS Confidential Case Report Forms
- HIV and HCV Testing Protocol (Word)
- OSHA BBP Exposure Control (Word)
- STD, HIV, and Hepatitis Risk Assessment (Optional template)
Data Collection Tools
- Outreach Data Collection Tool (Word)
- Condom Distribution Data Collection Tool (Word)