HIV Test Informed Consent Form

Updated September 29, 2021

An HIV informed consent form is used to allow a medical professional to perform an HIV antibody test on a patient. This test determines whether there is a presence of HIV antibodies within a patient’s body. The test will be made using a blood or oral sample taken from the patient. The form affirms that the patient understands the contagious nature of the virus and who will have the right to request to see the results of the test. This acknowledgment is important, because if the individual tests positive and spreads HIV/AIDS to another person, this document proves their foreknowledge of the risks of infecting others.

How to Write

Step 1 – Download in Adobe PDF.

Step 2 – Read through all of the important information regarding the HIV test and what the results will mean. If you wish to proceed with the test, provide the following information into the appropriate fields:

  • Name of person being tested
  • Date of birth
  • Signature
  • The date
  • Name and address of the person signing (if different from the person being tested)

Step 3 – The person performing the test will then need to provide the following:

  • Name of clinician or HIV tester
  • Signature of clinician or HIV tester
  • The date