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HIV 500 and 501 Registration

Florida Department of Health in Broward County

Contact

Post.CHD06@flhealth.gov
954-467-4700
DOH-Broward

Florida Department of Health in Broward County (DOH-Broward) HIV Prevention Program

HIV 500 and 501 Blended Learning Course Registration

Annual participation in the Florida Department of Health’s HIV Prevention Counseling, Testing, and Linkage course (HIV 501 Annual Update) is required for recertification of all counselors and testers to continue providing and conducting HIV prevention counseling, testing, and linkage.

To register for the training and receive confirmation of registration, please provide the following information for our records and complete the online form below.

Fields marked with an asterisk (*) are required.

Request Date for 500-501 course*

Name of Participant*

Participant Address*

Participant Email Address*

Participant Phone Number*

Testing Agency Name and DOH Site Number

Testing Site Manager Name

Testing Agency Address

Testing Agency City and Zip Code

Testing Agency Telephone Number*

Testing Site/Agency Name the Registrant will complete their post—requisites (perform HIV CTL under the supervision of certified staff who has a minimum of one year’s experience providing client centered HIV counseling, testing and linkage services)

Enter Confirmation Number