Community Table/Resource Listing Request
If you are representing a community organization that supports people living with or at risk of acquiring HIV in Oregon, and wish to table at the 2019 HIV Continuum of Care Conference please complete the form below. The conference committee is committed to sharing resources with attendees and will use the information provided to assign tabling space and list resources in the conference program. Please contact Dayna Morrison, Oregon AETC Program Manager with any questions:
Name of Person Completing this Form
Email of Person Completing this Form
Does your organization want to be listed in the conference program? Please note, priority will be given to organizations providing direct support to people living with HIV.
Do you want a table to share resource materials with conference participants?
If yes, how much space would you need? Please note priority will be given to organizations providing direct services to people living with HIV.
Name of Organization (to be listed in a resource directory)
Organization website (to be listed in a resource directory)
Organization Address (to be listed in a resource directory)
Organization Phone Number (to be listed in a resource directory)
Please provide a brief description of how your organization serves people along the HIV Care Continuum (200 words or less).
Does your organization receive Ryan White funding?
Please select the following services your organization provides (select all that applies)
HIV Prevention Services
PrEP prescribing and patient management
STI Screening: gonorrhea, chlamydia
STI Screening: syphilis
STI Screening: HIV
STI Screening: Hepatitis A, B, C
STI Screening: other
STI treatment: gonorrhea, chlamydia
STI treatment: syphilis
STI treatment: HIV
STI treatment: Hepatitis A, B, C
STI treatment: other
Housing Support Services
Case Management: HIV
Case Management: Other
Peer Support Services
Psychosocial Support Services
Mental Health Services
Syringe Service Programs
Domestic Violence Support
HIV Linkage to Care
Please select the specific populations with whom your organization works (please note categories reflect HRSA reporting requirements and may not represent all identities served by this event).
Older Adults (55+)
American Indian/Alaska Native
Black or African American
Hispanic or Latino/a
Hawaiian or Pacific Islander
Gay, Lesbian, Bisexual, or Transgender
Homeless or Unstably Housed
Incarcerated or Recently Incarcerated
Is there anything else we should know?
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