HIV Pre-Exposure Prophylaxis Course

HIV Pre-Exposure Prophylaxis Course – Registration form (#24)

Southern African HIV Clinicians Society

HIV Pre-Exposure Prophylaxis Course - Online Registration

Are you a Healthcare Professional? This continuing medical education resource is intended for use by Healthcare Professionals.

This training is for healthcare professionals. Non-healthcare professionals interested in partaking in the training to improve their knowledge and competence in HIV prevention can send a letter of motivation to sahivcs@sahivcs.org

Applicant Personal Information:

Title

First Name/s

(As it appears on ID or passport)

Surname

(As it appears on ID or passport)

ID/Passport Number

Country of issue

Cell Phone Number

Office / Work Phone Number

Email Address

Age

Home Language

Qualifications

Highest Degree/ Qualification

(e.g. MBBcH)

Year Obtained

Other Degree/ Qualification

Other Degree/ Qualification

Year Obtained

Year Obtained

Professional council name

Professional council number

Employment Details

Name of employing institution / organisation

Current job title

Country where you work

Country Other

Province where you work

Province Other

If other, please specify

What is your key purpose/motivation for undertaking this course?

Key purpose/motivation Other

Have you completed any SAHCS courses in the past?

Courses

Courses

Health Care Setting listing

Health Care Other

Service Context (select most applicable)

Service context - subset (select all that apply)

Would you like to be contacted with information to become a member of SAHCS? Membership for 2026 is free

Yes

Are you a SAHCS member?

Yes

Unsure

Please state membership number