Kansas Department of Health and Environment: Preliminary Positive Rapid Test/Confirmatory Sample

Preliminary Positive Rapid Test/Confirmatory

Sample Sent to Department of Health and

Environment Labs

Note: This site contains HIV prevention messages that may not be appropriate for all audiences. Since HIV infection is spread primarily through sexual practices or by sharing needles, prevention messages and programs may address these topics. If you are not seeking such information or may be offended by such materials, please exit this website.

Preliminary Positive Rapid Test/Confirmatory Sample Sent to
Department of Health and Environment Labs

* Denotes required fields.

* Requested by:

* Facility and Facility ID #:

* Facility mailing address:

* HIV Test Form Client ID#: (Barcode # from the Universal Lab Specimen Form)

* HIV Test Form ID#: (Barcode # From The HIV Test Form)

* Session date and Sample Date:

* Date of Birth:

Comments or Questions:

Please enter comments or questions here.

Questions: Contact (785) 296-4449 or Fax: (785) 296-4197

Preliminary Positive Rapid Test/ConfirmatorySample Sent to Department of Health andEnvironment Labs

Preliminary Positive Rapid Test/Confirmatory Sample Sent to Department of Health and Environment Labs

Preliminary Positive Rapid Test/Confirmatory

Sample Sent to Department of Health and

Environment Labs

Preliminary Positive Rapid Test/Confirmatory Sample Sent to
Department of Health and Environment Labs