This form collects information about you so that we may help you safely access an at-home HIV testing kit and so that we may provide you assistance in the process. By completing this form, you consent to AIDS Project Rhode Island (APRI) contacting you and utilizing the information you provide to assist you. APRI will not release any of the information you provide except by your written consent or as in accordance with any applicable law. This information collected is HIPAA compliant. Only those who will be directly assisting you and those who assist APRI with administering this program will have access to it. All information will be stored in a secure manner. APRI may utilize the information you provide in the aggregate without identifying information so that it may produce reports or complete other essential operational functions.
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