The forms listed here are for our currently enrolled patients. Please contact us if you have any questions or need assistance. Not yet enrolled? Click here to get started.
Apply For PrEP DAP
If you are uninsured, you may apply for PrEP coverage through the Washington State Department of Health assistance program, PrEP DAP. Washington DOH created this program to decrease barriers to your care. Renewal is required once yearly. Apply below.
Apply for Gilead PAP/Copay Card
The manufacturer of both Truvada® and Descovy®, Gilead, also offers patient assistance. Our team will help you navigate this service and keep track of the variable renewal timelines. Follow the links below to apply and learn more.
One-Step PrEP® Patient Intake & Consent Form
Following your initial screening appointment with a Kelley-Ross Pharmacy provider, you will be asked to complete this Patient Intake & Consent form.
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Patient Bill of Rights and Responsibilities
This document contains a list of your rights and responsibilities as a Kelley-Ross Pharmacy client.
HIPAA Authorization
We need your permission to communicate with your other medical providers. Follow the link to let us be a part of your healthcare team