HIV Prevention Program


Submit quarterly Affidavits of Expenditures to report on expenditures on budget line items such as salaries, materials, transportation, and indirect costs.

Submit Quarterly Reporting Forms to report on contract activities each quarter.

Enter CDC HIV Test Form data into Evaluation Web for each HIV test conducted using KDHE funds. Test data should be entered into EvaluationWeb no later than 30 days after the date of a conventional test and no later than 72 hours after the date of rapid test.

Submit an Adult Case Report Form for every confirmed HIV-positive test result no later than 7 days after receipt of confirmed positive test results.

Complete and submit Rapid Test Log no later than the 15th of each month.


Program Contacts

Stephanie Green, STI/HIV Prevention Program Manager


Forms Required:

Certified Affidavit of Community HIV Prevention Services of Expenditures


Community HIV Prevention Services Quarterly Report |


Certified Opt-Out Testing Affidavit of Expenditures

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Adult Case Report Form


HIV Test Form


Rapid Test Log Template