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    DSHS HIV/STD Program

    Post Office Box 149347, MC 1873
    Austin, Texas 78714

    Phone: (512) 533-3000

    DSHS strives to respond to all email requests in a timely manner. It is important to note, however, that messages that you send to us by email may not be secure and may be intercepted by a third party. Therefore, we recommend that you do not send any confidential health information to us by email.

Texas HIV Medication Program – Documents

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Client Application - the THMP application for assistance is available in English and Spanish in Word and PDF formats. The application includes the supplemental SPAP application page as part of the formal application process, for those clients with Medicare coverage. (updated April 2014)

Updated Medical Certification Form (MCF) (PDF : 79 kb) - allows physicians to request any and all medications currently available through the THMP. Please note that a separate form for the drug Fuzeon (enfuvirtide) is no longer required. (updated October 2013)

It is recommended that patients initiating Fuzeon treatment receive additional training and support through Nurse Connections. This service is provided free to new and existing patients. For information or to enroll a patient, please call 1-877-4Fuzeon (1-877-438-9366).

Guidelines (PDF : 200 kb) - program guidelines for THMP applicants. (updated October 2013)

Guidelines (Español) (PDF : 44 kb) - a Spanish translation of the THMP guidelines. (note: the Spanish version of the guidelines was last updated in 2007; an newer version is still awaiting translation)

THMP Formulary (PDF : 75 kb) - the list of drugs currently available through the THMP. (updated October 2013)

Pharmacy Guidelines (PDF : 136 kb) - program guidelines for participating THMP pharmacies. (updated October 2013)

Pharmacy Memorandum of Agreement (MOA) (PDF : 56 kb) - the actual form that pharmacists complete in order to become a participating THMP pharmacy.

To view and download documents related to the HIV SPAP (State Pharmaceutical Assistance Program), please visit the TEXAS HIV SPAP page.


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Last updated April 25, 2014