Together, we can stop HIV & AIDS

HIV/AIDS Drug Request Prescription Form

The HIV/AIDS Drug Request Prescription Form (PDF) may be downloaded here. Paper copies of the form may be requested from the BC-CfE HIV Drug Treatment Program. Information about how to complete the prescription form can be found in the next section.

For information on how to use this form, and to learn about program eligibility, enrolment, and obtaining HIV medication in BC, please click here.

Providence Health Care UBC

Copyright BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital
608 - 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6
General Telephone: 604-806-8477 | Fax: 604-806-9044
Email: info@cfenet.ubc.ca