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COVID-19
Services & Resources
Current PHNTX Services
COVID-19 Testing
Telehealth & Telepsychiatry
Resources
Services
Full-Spectrum Care
Your First Visit
HIV Primary Care
STI Testing & Treatment
PrEP (Pre-Exposure Prophylaxis)
Transgender Primary Care
Behavioral Health
Case Management
Pharmacy
Telehealth & Telepsychiatry
Additional Services
Free Condoms – Nice Package
Empowerment Connection
Free World Bound
Health Insurance Marketplace Navigator
Insurance and Financial Assistance
On-Site Laboratory
Dermatology
Clinical Research
Find Community Resources
Education & Training
Resources & Education
HIV Basics
HIV Stigma
Empowerment Connection
Beneath the Briefs Podcast
Resources & FAQs
Find Community Resources
Professional Training
AIDS Education & Training Center
Get Involved
Ways to Support PHNTX
Give Back
LifeWalk
Events
Volunteer
About
Who We Are
About PHNTX
Locations
News
Careers
Contact Us
Locations
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Contact Us
SCAETC Service Request Form
Step
1
of
5
20%
What service(s) does your practice need?
*
Select all that applies.
Education (trainings, workshops, clinical & behavioral health preceptorships)
Clinical Case Consultations & Communities of Practice (provider to provider)
Technical Assistance & Practice Transformation
Education - Trainings, Workshops, Clinical & Behavioral Health Preceptorships
Which primary audiences require the training/education?
What is the training topic needed for the requested education?
What is your preferred training modality?
Webinar
Face-to-Face
On Demand
Clinical Case Consultations & Communities of Practice - Provider to Provider
What is the topic of interest for the requested cast consultation/CoP?
Technical Assistance & Practice Transformation
What is the topic of interest for the requested for the Technical Assistance or Practice Transformation?
Name
*
First
Last
Your title or role at your organization
*
Email
*
Phone
*
Your preferred method of contact
*
Email
Phone
Either is okay.
Please provide 2-3 dates and times that you are available to discuss the request
*
Our office will follow up with a call or email to schedule the meeting.
Date
Time
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