TelePrEP by Novus

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Please verify that you are human* This field is required.
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What state do you live in?* This field is required.
Pennsylvania
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Name.* This field is required.Please enter your full legal name as it appears on your ID and Insurance cards
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Date of Birth* This field is required.Please use your real birth date, not the fake one! Thx
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Email* This field is required.We'll need an email to complete the set up of your patient account
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Receiving the email may take a few minutes, thank you for your patience!
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Terms and Conditions* This field is required.I have read and understand the documents and consents to Telehealth, Telehealth Terms of Use, Privacy, Notice of Practice Privacy Policy, HIV and or STI testing.
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What type of insurance coverage will you be using?* This field is required.
Private Insurance
Medicaid/Medicare
Gilead Advancing Access
I'm getting insurance soon!
No Insurance
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At Novus Medical Services, we're dedicated to providing accessible PrEP services for HIV prevention. While our TelePrEP program currently serves those with insurance, we want to ensure everyone has options for care.

For those without insurance, we warmly invite you to visit us for an in-office consultation. You can easily schedule an appointment at a location convenient for you by clicking here.

Additionally, we're here to guide you every step of the way and can connect you with our trusted partners in Pennsylvania who offer TelePrEP services. They're ready to assist you with the support you need!

Click here for the self-referral form

Click here to learn more about ACG
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Would you like to finish your intake now, or later?* This field is required.
Finish now
Email the intake, I'll complete it later!
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Please take a photo of the front of your ID Card* This field is required.Government issued ID cards only please. For example, Passport, Driver's License, State ID card, Military ID, etc.
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Max. file size: 10.6MB
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Please take a photo of the FRONT of your insurance card.* This field is required.
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Please take a photo of the BACK of your insurance card.* This field is required.
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What was your gender at birth?* This field is required.
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What gender do you currently identify with?* This field is required.
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What sexual orientation do you currently identify with?* This field is required.
Bisexual
Females who has sex with Females
Females who has sex with Males
Male who has sex with Females
Male who has sex with Males
Pansexual
Other
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Have you ever been diagnosis as a person who is living with HIV?* This field is required.
No
Yes
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We're sorry, currently we're only offering online PrEP for HIV care. We will be adding online HIV care to our services in the near future. Please contact the closest Novus Medical Services office to obtain care for HIV.

Call us at (610)867-5365 or visit at

www.novusacs.com
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Have you been exposed to HIV in the last 72 hours?* This field is required.
No
Yes
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This is an emergency situation, but stay calm you got this. If you have been exposed to HIV within the last 72 hours, you need to go to the closest Emergency Room, Novus Medical Services Office, or another STI clinic and request PEP (Post Exposure Prophylaxis) as soon as possible.

If you need to talk to someone please call us at (610)867-5365 for more information.
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Sexual Practices (select all that apply)* This field is required.
Top Only
Versatile/Switch
Bottom Only
Rimming
Oral
Toys
Mutual Masturbation
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Vaginal
Other
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How many sexual partners have you had in the last 3 months?* This field is required.
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Have you had an HIV test?* This field is required.
Yes
No
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What was the results of your HIV test?* This field is required.
Negative
Positive
Indeterminate
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We're sorry if you tested positive for HIV, we're currently not offering online care yet, but we plan to be soon! If you received indeterminate results from an HIV test, then we would like to see you in office. Please visit our website at www.novusacs.com to contact the closest office. Thank you!
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Book your telehealth consultation visit* This field is required.
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Great, we're all done with the personal questions!* This field is required.Novus TelePrEP is not responsible for your copays on any lab work.
Lab testing - We'll email you a lab slip, and you go to your insurance carrier's preferred lab (Quest, Labcorp, etc) and have the lab work completed there.
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