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Program Eligibility

Please answer the following questions about the patient.

Has the patient injected drugs, or had sex with someone who injects drugs?

Yes No Don't know

Has the patient ever had hepatitis C?

Yes No Don't know

Has the patient ever been diagnosed with syphilis?

Yes No Don't know

Is the patient living with HIV?

Yes No Don't know

Test Your Way is your sexual health e-service that provides free and easy access to sexual health testing via the internet.
All testing is done in a CLIA approved, CAP accredited lab.

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Emily Johnson, 7825 Winding Ridge Road, Charlotte, NC 28277

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