Header Image

Alabama AIDS Drug Assistance Program

The goal of the Alabama AIDS Drug Assistance Program (ADAP) is to reduce associated morbidity/mortality among HIV infected persons by delaying the progression of HIV disease through prevention and treatment of HIV complications.

ADAP Quarterly Report

The ADAP Quarterly Report for April 2012 - March 2013 is now available. This report reflects the number of active clients enrolled in the AIDS Drug Assistance Program.

ADAP Satisfaction Survey

The ADAP Satisfaction Survey is designed to help improve ADAP medication services. The survey should take approximately 5-10 minutes to complete, and answers and comments will remain anonymous. Take the survey.

ADAP Patient Activity Capped Enrollment (1700)

Updated:

May 15, 2013

Active:

1700

Medcap:

90

Waiting:

66

 

 

Forms

Last Revised

ADAP Mission Statement and Goal

April 2012

ADAP Formulary

September 2012

ADAP Manifestación de certificación del cliente

January 2009

Universal Monitoring Standards for Ryan White Part A and B Grantees

May 2013

Monitoring Expectations for Ryan White Part B Grantees

May 2013

Alabama Ryan White Part B Services/ADAP/MEDCAP Standard Application

May 2013

ADAP Eligibility Criteria

May 2013

ADAP Certification Statement

May 2013

ADAP Temporary Housing Statement

May 2013

ADAP/MEDCAP Medication Order Form

May 2013

ADAP Six Month Eligibility Reassessment Form

May 2013

ADAP Six Month Eligibility Process

May 2013

ADAP Medication Revision Process

May 2013

ADAP Prescription Revision Form

May 2013

Fuzeon Pre-Approval Checklist

May 2011

Maraviroc (Selzentry™) Pre-Authorization Form

May 2011

ADAP Procrit Pre-Approval Form

May 2011

MEDCAP Enrollment Requirements

October 2012

MEDCAP Checklist

October 2012

MEDCAP Client Certification Statement

October 2011