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HIV Test Informed Consent Form

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Updated November 12, 2024

An HIV informed consent form is used by a medical professional to request a patient's consent to HIV testing. The test uses blood or oral samples taken from the patient to determine the presence or absence of HIV antibodies in the patient's system.

How to Write

Step 1 – Download in 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