Partner/Friend/Relative Information

If you have already been interviewed by a DIS or healthcare worker please share the names and information needed, as much as you can remember, on  your partners, friends and relatives that you know might be at risk for STIs so that they could be tested and treated if needed.

Examples include:

 1) People you have had sex with.

 2) The person who you thought may have infected you
 3) Friends or relatives that you know about that may have symptoms of an STI
 4) Friends that you shared the same sex partners with.
 5) People that you hang out with such as friends and acquaintances with whom you have not had sex with.
 6) Friends and relatives (no sexual contact) that could benefit from a free test.

It is very important that these individuals get tested for STIs even if you have not had sex with them.

Just remember that we are committed to confidentiality and your privacy is safe with us. Your entries will never be stored on this website. 

1) Please enter your name and date of birth, or any other means (code) of identifying who you are. 

2) Enter your partner/friend/relative's information.


All required fields are tagged with an asterisk (*). Please type (na) if field is not known. 
 

If you are finished with your entries, click on the "Home" button, "log out", and/or exit website.

Thank you for your cooperation. You have made Houston's health sexually safer.