Provider Directory Listing Request

Pre-Exposure Prophylaxis Provider Directory Listing Request

The Los Angeles County Division of HIV and STD Programs (DHSP) fully supports the use of HIV biomedical interventions (PrEP/ PEP) as critical components of comprehensive medical services for individuals at high risk for HIV. If you are a provider of PrEP services and would like to be listed in the Los Angeles County PrEP Provider Directory, please provide the information below.


Special populations served (place select all that apply) :
Ages (13-17)Ages (18-28)Transgender IndividualsMen who have sex with menSubstance usersHIV + individuals

Language(s) spoken:
EnglishSpanish


Is there a PrEP Navigator* at your clinic/practice? (see definition below)
YesNo

If yes, complete the information below. If no, instead provide the contact name of someone who is familiar with PrEP and appointment scheduling below.

* At a minimum, a PrEP Navigator is an individual who has a strong working knowledge of PrEP and understands how PrEP is paid for, including insurance, medication/patient financial assistance programs. The Navigator should be able to refer to other services that can assist the patient with paying for PrEP.


Does your clinic/practice provide PrEP starter packs? (5-7 days of medication while prior authorization or patient/medication assistance applications are being processed)
YesNo

Do you have a pharmacy or dispensary on site?
YesNo

On average, how long does it take for someone to get an appointment with a medical provider to initiate/discuss PrEP?

Approximately how many patients do you currently have on PrEP at your clinic/practice?

Additional information you would like to provide about your clinic:

Information provided in this section is for DHSP internal purposes only and will not appear in the directory.


Insurance Information

Do you accept any of the following? Check all that apply.
Medi-CalMedi-Cal Managed CareMedicareMy Health LA

Do you have an insurance enrollment specialist on staff? Check all that apply.
Covered CaliforniaMedi-Cal

Does your clinic/practice have someone to process medication/patient financial assistance forms?
YesNo

List other types of insurance that your clinic accepts. Please indicate if insurance is an HMO and/or PPO.

1 HMOPPO
2 HMOPPO
3 HMOPPO
4 HMOPPO
5 HMOPPO
6 HMOPPO
7 HMOPPO
8 HMOPPO
9 HMOPPO
10 HMOPPO

If you know of other clinics that would like to be listed in this directory please provide their contact information.


The submission of this document must include the contact information of an individual who should be in a position to authorize the posting of this listing on the www.getprepla.com website. The individual will be responsible for ensuring that the information listed in the PrEP Provider Directory is accurate and will contact DHSP if there are changes. NOTE: This person’s contact will not be shared on our website and is for contact purposes only.

For questions contact Aletha Wild at 213-351-1125. Please note that inclusion in this directory is voluntary and does not confer any endorsement by the County of Los Angeles, nor does it establish county credentialing of any type. DHSP reserves the right to remove a provider listing for any reason that we feel may compromise a patient’s ability to receive timely and/or competent care.