Request HIV, Hepatitis C, and/or STD Testing

Please fill out the form below and hit “Submit.” A member of our Education and Prevention staff will be in touch soon.

If you experience difficulties with submitting this form or get an error message, please email us at or send a text to (845) 704-7624. We will respond as soon as possible. We are sorry for the website error and are working to fix it quickly. Thank you for your patience.

    Your mobile phone number

    Is English your primary language? If not, we can provide language translation. \ ¿Es el inglés su idioma principal? Si no, podemos proporcionar traducción de idiomas.

    When you have sex, do you have sex with... (check all that apply)?

    Have you ever had sex without a condom?

    Have you ever shared needles for any purpose?

    What type of testing are you interested in?

    Are you looking for testing at one of our events? If so, please indicate below.