Ryan White Primary and Specialty Care (Medical and Dental) Services
The following documents are intended for Ryan White Primary Care Providers.
Forms
Enrollment
Clinic, Lab, and Pharmacy
- Drug Formulary
-
Resistance Test
Form*
- RWPC Allowable Dental Services
- RWPC Dental Practice Guidelines
- RWPC Excluded Procedure Codes
- RWPC Standards of Care Committee Practice Guidelines
- RWPC Medical Practice Guidelines
- RWPC Nutritional Supplement Form
-
Sexual
Health Risk Assessment English
- Sexual Health Risk Assessment Spanish
- Specialty Care Authorization Form—Medical
- Specialty Care Authorization Form—Dental
- Specialty Care Authorization Form—Home Health and Hospice
- Viral Load Test Form*
-
Provider Registration Form
Case Management
Resources
- HRSA Ryan White HIV/AIDS Program Performance Measures
- Ryan White Primary Care Contract Administrator—(619) 293-4716; please contact us if you have any questions.
Popular Services