Give yourself the perfect opportunity to live a healthy and happy life in the lovely warm-weather community of Palm Springs, with Desert AIDS Project.

To learn how to become a client or patient, you can fill out the form below or you can call and leave a message on the Enrollment Line at 760-323-2118 ext. 762. An enrollment specialist will contact you shortly after.

Enroll

Download and print the Enrollment Form:
English
Spanish

Adult Health History Form:
Use to fill form out on a computer or tablet, print and bring with you
Use to print and fill out by hand and bring with you

Required items needed for enrollment:

  • Identification

See Insurance and Payments for more information on our low-cost payments and sliding fee scale. No one will be turned away due to an inability to pay.

HIV-positive patients
In addition to the above enrollment form, please download and print the HIV Health History Form:
HIV Health History – English
HIV Health History – Spanish

The following additional documentation might be necessary to determine eligibility for additional services for those living with HIV:

  • Proof of Insurance or Income: See Insurance and Payments for more information.
  • Proof of Riverside/San Bernardino County Residency
  • Proof of HIV Diagnosis

Translation services

Language and American Sign Language translation services are available, please select the check box below and select your preferred language. (Servicios de traducción de idiomas están disponibles, por favor selecciona la caja de abajo y seleccione su idioma preferido.)
Contact us today to make an appointment with an Enrollment Specialist!

First Name*

Last Name*

Email Address*

Phone Number*

Best way to reach you

Best time to reach you

Have you been recently diagnosed with HIV or been out of care for a long time?
YesNo


Services you're interested in

Translation services
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