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PrEP Eligibility Checker
Step
1
of
2
50%
Tick ONE of the following that describes you
I am a man who has sex with men
I am a transgender woman who has sex with men
Trans man who has sex with men
I am having sex without condoms with HIV positive partners
Have you had anal sex without condoms with more than one partner in the last 6 months
YES
NO
Have you had a sexually transmitted infection (STI) in the last year
YES
NO
Have you used HIV post-exposure prophylaxis (PEP) in the last year
YES
NO
Have you used recreational drugs for sex (also known as ChemSex) in the last 6 months
YES
NO
Are you planning on having unprotected sex in the near future
YES
NO
Are the HIV Positive partners on HIV Treatment
YES
NO
Do they have an "undetectable" viral load
YES
NO
1 YES you are eligible for FREE PREP
1 -Do you want Nassau Clinic to assist you to register for FREE PrEP
(Required)
YES
NO
1 You will be asked for your PPSN (Personal Public Service Number)
2 YES you are eligible for FREE PREP
2 -Do you want Nassau Clinic to assist you to register for FREE PrEP
(Required)
YES
NO
2 You will be asked for your PPSN (Personal Public Service Number)
Do you authorise the Nassau Clinic to communicate with you by SMS
(Required)
YES
NO
You must give permission to us to send you an SMS regarding our services.
Do you have a PPSN (Personal Public Service Number)
(Required)
YES
NO
Type Your PPSN (Personal Public Service Number) below
(Required)
What is your First Name
What is your Last Name (family name)
What is your Date of Birth
(Required)
DD slash MM slash YYYY
What is your mobile telphone number
(Required)
What is your email address
(Required)
What is your EIRCODE
(Required)
What is your ADDRESS
(Required)
Do you already have a Medical Card
(Required)
YES
NO
Type Your Medical Card Number below
(Required)
Do you already have a Drug Payment Scheme (DPS) Card
(Required)
YES
NO
Type Your Drug Payment Card Number below
(Required)
Have you attended the Nassau Clinic Dublin or Dr Liam REGAN before
(Required)
In a life-Threatening Emergency Dial 999 or 112