AIDS CARE
PROJECT
There are eligibility requirements for the AIDS Care
Project Program. Please call Keku'i Ledward at 617-859-3036 ext
290 to discuss program options.
To setup
an initial appointment,
You should
pick up the necessary paperwork in advance or you may download the necessary
forms. Paperwork must be approved prior to treatment if you wish to
take advantage of the low cost ACP Program.
You will
need to have a primary care physician's consent for us to treat, a verification
of HIV status from medical facility or M.D. and you will need to provide
income verification.
To download
the intake forms, click on the links below, fill them out completely
and fax them to us at 617-859-0965 or bring them in with you. We need
each of the following completed forms to process your intake:
- Intake form [all 7 pages]
-
Informed Consent form
- Financial
Intake form
-
Privacy Policy: for your information
- Authorization for Consent to Review
- Doctor's Referral
- Grievance Procedure
If you have any questions on
how to fill out the forms, please call our receptionist at 617-859-3036
ext 0.
For more detailed information
on acupuncture, herbal treatments, and massage, please download
this form.
We look forward to providing
you with excellent care.
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