Contact information

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Contact information

Thank you for your interest in the HIV provider intervention study to understand and address intersectional stigma and medical mistrust!

Please leave your contact information; our research team will reach out to you about the next steps.

Please be prepared to provide information (e.g., work email, online profile) so that we can verify your work affiliation.

Name *

Email (for scheduling and receiving study information) *

Phone number (for scheduling and participating in a phone screen) *

What is the best way to reach you? *

Phone call

Other:

In what capacity do you work with HIV patients or clients? *

Please provide your work email address (so we can verify your work affiliation) *

Which hospital, clinic, or health center are you affiliated with? *

What is your job title? (Please provide enough details so we can verify your work affiliation) *

What is your clinical/medical specialty? (Please provide enough details so we can verify your work affiliation) *

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