Step 1: HIV Testing Site Readiness Form and Checklist

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Applicants are required to review the relevant requirements that pertain to their
facilities and ensure that the criteria are understood and met, before submitting the
Application to Establish an HIV Rapid Testing Site. The HIV Rapid Test Improvement
Team (HRTIT) will utilize this assessment tool to determine the readiness for
establishing an HIV Rapid Testing Site. The HRTIT will only conduct an assessment
after a completed application has been submitted to the HIV and AIDS Coordinating
Unit.

Email *

Organizational Profile

Reporting Supervisory Body/Office

Region *

County *

Name of Site Focal Point

Affiliation *

Public Health Sector

Private Sector

Faith-Based Organization (FBO)

Non-Governmental Organization (NGO)

Test Facility

Location/Address

Number of certified HIV Rapid Testers *

Number of certified Provider Initiated Testing & Counseling providers *

Days and Time of Testing *

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