Documents Needed for Intake
You must reside within the five (5) boroughs of NYC to be eligible for GMHC services.
What’s on This Page
HIV Positive Intake Information (4 documents)
- Most recent medical labs showing CD4 count and Viral load
- Diagnosis listing or health summary that includes HIV on it
- State identification card (NYS State ID, NYC Photo ID, Passport ID, VISA, etc.)
- Insurance Verification (EBT, Medicaid card, ADAP, etc.)
If you cannot obtain the diagnosis listing, then you must submit one (1) of the following supporting documents listed below:
- Letter from your Primary Care provider stating you are in their care for HIV
- M11q Form
- Detectable viral load (even if it's an past lab result)
HIV Negative Intake Information (2 documents)
- State identification card (NYS State Id, NYC Photo ID, Passport id, VISA, etc.)
- Insurance Verification (EBT, Medicaid card, ADAP, etc.)
Contact
Denise Roman, Intake Coordinator, at DeniseR@gmhc.org or Ph. 212-367-1133.
Please note: All documents must be received before an appointment can be scheduled.
