Testing to Go
In efforts to continue to provide free HIV testing and counseling services throughout COVID-19, NAP offices in Omaha, Lincoln and Kearney are offering Testing to Go. An easy to use HIV self-testing kit will be mailed or you can schedule a pick-up at our Omaha and Lincoln offices at no cost (some conditions do apply). There is no blood needed— just swab your gum line and results are ready in 20 minutes. Interested? Please complete the form below and a member of our team will contact you. Request are responded to within 24-48 hours. ( Not including weekends or holidays)
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Phone
*
-
Area Code
Phone Number
Email
*
example@example.com
Are you at least 19 years of age?
*
Yes
No
Enter your date of birth
*
-
Month
-
Day
Year
Date
best time to contact?
*
morning
afternoon
evening
Do you have any concerns about your ability to administer the self- test kit? ( or your ability to perform the test kit yourself?)
*
Yes
No
Do you understand that you will need to report your test results back to NAP upon completion and that a member of our staff will be reaching out to you for a follow-up if we have not heard from you within a week?
*
Yes
No
Do you understand that HIV tests are completely confidential and that your information is protected and will not be shared with anyone without written permission,except to the Health Department if the result of your test kit is a preliminary reactive in efforts to help you get the care that you would need.
*
Yes
No
I would like to receive my test via:
USPS (mail)
Schedule a pick up
By clicking this check box, I acknowledge that I have provided a phone number and email address above. I also authorize the NAP staff to contact me regarding my request.
*
I Acknowledge
I understand the information I have provided is completely confidential and will not be shared with anyone outside of a preliminary reactive result. By signing, I acknowledge the information provided is true to the best of my knowledge and I agree to have NAP staff contact me to discuss next steps for my participation in the self testing program.
*
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Submit
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