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Tell us about your test

Please let us know if you succeeded in getting a viral load test. If not, please tell us why not. This will help give us a better picture of where and why viral load tests are not available. We will use this information in the ‘Be Healthy – Know your viral load’ campaign. See other suggested actions.

Given (first) name (required)

Family (second) name (required)

Name of clinic:

Address of clinic:

Province:

Country:

Did you succeed in getting a viral load test:
yes 
no 

If yes, was the test offered to you or did you request it (either or option)
The test was offered to me 
I requested the test 

If no, please state the reason:

Too expensive for me, please state how much:

Other, please state the reason:

When did you have your last viral load test?

Please provide your email address to stay in touch with the campaign. (optional)

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