Revised HIV Testing Consent Form -- Pre-test Counseling and Consent for HIV Testing (Form 10-0121), November 2004
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Dear Colleagues: As part of ongoing efforts to reduce barriers and increase access to HIV testing, the Public Health Strategic Health Care Group (PHSHG) is pleased to announce the release of a revised HIV Testing Consent Form. This form retains the designation VA Form 10-0121 and is now available online. Print copies will also be distributed to each VA Medical Center and will be available in the Publications Depot as well. Existing stock of VA form 10-0121, Dec 1988 will no longer be used. This form, 'Pre-test Counseling and Consent for HIV Testing', does not represent a change in VHA policy on the requirement for written informed consent or essential required elements for pre-test counseling. Instead, this form provides information about HIV testing designed to answer the patient's questions about testing, such as the HIV test procedures, the benefits and possible risks of the test, and the meaning of test results. This revised form also will address the required elements of pre-test counseling for the provider who had not routinely provided HIV pre- test counseling in the past.
In addition, this form has been developed in coordination with the VHA National Center for Ethics to be compatible with the iMedConsent software that will ultimately provide a standardized electronic process to guide informed-consent discussions between doctors and patients. This content of this revised form is identical to the content that will eventually be used when iMedConsent has been adopted nationally.
Along with other upcoming initiatives, it is hoped that this revised form will help decrease barriers to HIV testing while maintaining compliance with Federal laws and VA regulations. The PHSHG urges all VA providers to make risk assessment and testing for HIV, sexually transmitted diseases, and other chronic viral infections, such as hepatitis B and hepatitis C, a routine part of medical care.
Please contact either of us if you have any questions or concerns regarding this information.
Sincerely,
Michael Rigsby, MD
Director, HIV and Hepatitis C Program Office
Kim Hamlett-Berry, PhD
Director, Public Health National Prevention Program
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