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Clinician Inquiry Form

CEI provides this online form for clinicians in New York State to discuss PEP, PrEP, HIV, HCV, Drug User Health and Sexual Health patient management with a specialist.

We support inquiries from NYS clinicians in the following disciplines: MD/DO, NP, PA, RN, PharmD or DDS.

This form is not intended for patient or consumer inquiry.

Please be aware it may take up to 72 hours to respond to your inquiry.

For immediate response call CEI Line: 866-637-2342.

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Your name: *
Are you a clinician (MD/DO, NP, PA, RN, PharmD or DDS)?*
- Yes
- No
Your phone number: *
Your email:*
Topic of your question: *
- HIV PEP
- HIV PrEP
- HIV
- HCV
- SH
Your question: *

(Please refrain from using any patient identifier or protected health information)

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