Clinic Registration Promote your HIV services on the Manitoba HIV Program HIV Services Map by filling in the form below. You can also view the map.Organization DetailsThis section includes elements that WILL be visible on the websiteClinic / Org Name(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Website Email PhoneServices HIV Treatment & Care Post-exposure Prophylaxis (PEP) Follow-up Pre-exposure Prophylaxis (PrEP) Service Notes To be used only for highlighting service availabilities or limitations. E.g. Services for a specific demographic (women, indigenous); wheelchair accessibility;Contact DetailsPlease supply a contact at your organization that the Manitoba HIV Program can contact for questions or more details. This information will NOT be published on the services map and is for internal use only.Name(Required) First Last Contact Title / Role(Required) Contact Email(Required) Contact Phone Number(Required)
