Sexual health - PrEP online request form | Kent Community Health NHS Foundation Trust

We are making it easier for people taking PrEP to continue to access this. Should you choose to continue, you will be asked to complete a few questions online. A clinician will then review your completed self-assessment and we will then contact you with advice on what to do next.

Please note that we will be unable to review any symptoms or treat any infections during this type of PrEP appointment. If you have symptoms, need treatment for an infection, are due a vaccination, please call 0300 7900 0245 or 0300 123 1678.

This option is unsuitable for people who get PrEP via commercial trials or who would like to start PrEP (for example, if you have never had PrEP before, or if you have had a break from PrEP).

Demographics

Postcode(Required)

Gender(Required)

Is gender the same since birth?(Required)

Ethnicity(Required)

Other, please specify

Country(Required)

Medical history

Please specify medical condition(s)(Required)

Please specify medication/supplements(Required)

If you have periods, please tell us when your last period was?

Sexual Health assessment

Risk assessment history

PrEP risk and exposure

Please specify(Required)

How do you take your Prep?(Required)

Please specify box opens(Required)

Number of missed pills?(Required)

Reason(s) for missed pills?(Required)

Approximate date of your last HIV test

Result of last HIV test

Which site would you like to attend?(Required)

Completed date(Required)

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Sexual health – PrEP online request form

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