Refer a Patient

Connect your patients with free, confidential HIV/STI navigation services. Our bilingual care navigators follow up within 1–5 business days depending on urgency.

HIPAA Compliant

Secure, confidential intake

All Services Free

No cost to patients or providers

3-County Coverage

Pasco · Pinellas · Hillsborough

Referral Urgency

Select the urgency level for this referral.

Referring Provider Information

We will contact you to confirm enrollment and provide follow-up.

Provider Name *

Practice / Organization

Provider Email *

Provider Phone

Patient Information

To protect patient privacy, we only collect first name and last initial. Full name is not required.

Patient First Name *

Last Initial *

Date of Birth

Patient Phone

Services Requested *

Select all services this patient needs.

PrEP Navigation & Linkage to CarePEP Navigation (Post-Exposure Prophylaxis)HIV Testing & CounselingHIV Care Linkage (newly diagnosed)STI Testing & Treatment ReferralGeneral Patient NavigationRyan White Program EnrollmentHealth Education & Counseling

Clinical Notes

Optional: include any relevant clinical context to help our navigator prepare.

Provider Attestation

I confirm that I have obtained the patient's verbal or written consent to share their information with Project Health Outreach Inc. for the purpose of care coordination and navigation services. I understand that all information will be handled in accordance with HIPAA regulations.

Questions? Call us at 727-226-7844

Need to Reach Us Directly?

Phone

727-226-7844

[email protected]

Office

2435 US 19 S, Suite 232
Holiday, FL 34691

Mon–Fri 9AM–5PM EST

Get Tested Free