East Bay Linkage & Retention Network Directory Form
Please complete this form on behalf of your organization in regards to informing the public and HIV providers in the network around your services offered - specifically around HIV, linkage to care, PrEP, etc. When accessing the directory, you can find a wide variety of HIV-related services (primarily in Alameda and Contra Costa counties).
To view what other orgs have included, visit the EBGTZ website: https://www.ebgtz.org/services/

Questions? email us at info@ebgtz.org
 
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Email *
Is this a new listing? An updated listing?
Agency (include multiple clinics if applicable):
Website:
Address (include multiple clinic addresses if applicable):
Contact Information (this includes direct phone numbers and emails - single point of contact for warm hand offs, linkage, etc):
When folks are searching for different categories, please indicate the top 3 primary services / categories to be included for your agency:
When folks are searching for different categories, please indicate the secondary services / categories to be included for your agency:
Who do you welcome? (an example of this: "new patients, uninsured patients and most insurance plans")
Same-day access and availability (example of this: "Urgent same-day provider visits are available"):
Please bring (example of this: "ID, letter of diagnosis or HIV lab results, other past labs if available"):
Hours:
Highlighted Services (example for this: "HIV care and treatment, Same-day HIV prescriptions (rapid ART)"):
Names of Providers:
Languages Available:
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