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Registering For
Select all programs that you are registering for.
EPT Eligibility Requirements
All participating clinic sites and LHJs must:
This may be demonstrated by meeting one or more of the following criteria:
  • Affiliation with local health jurisdiction
  • Designation as a Federally Qualified Health Center (FQHC), FQHC Look-Alike, or Rural Health Clinic (RHC)
  • Member of a community clinic consortium
  • Participation in the 340B Drug Pricing Program
  • Receipt of Ryan White funding
  • Receipt of Title X funding
  • Site pre-approved by Essential Access Health
Treatment
Each clinic site that registers for the CT/GC EPT Distribution Program, must provide CT/GC treatment to patients who test positive at the clinic site(s) (this does not include providing a prescription to be filled at an unaffiliated pharmacy). Please indicate how your clinic site is currently providing CT and GC treatment to index patients:
EPT Information
EPT Sites
Site Type
To meet the requirement of serving a population that is uninsured or underinsured, this site…
select all that apply
To meet the requirement of delivery of index patient chlamydia and gonorrhea treatment, this site will…
select all that apply
Additional Contact Information
Terms and Conditions

All clinic sites and local health jurisdictions (LHJs) receiving medication from Essential Access Health through the Chlamydia/Gonorrhea (CT/GC) expedited partner therapy (EPT) Distribution Program must agree to the following terms and conditions:

  • Distribute medication from the CT/GC EPT Distribution Program only to patient’s whose partner(s) are (a) unable or unlikely to seek prompt clinical services and (b) who they believe to be uninsured/underinsured. LHJs may also provide the medication to index patients during FDT, as appropriate.''
  • Distribute medication from the CT/GC EPT Distribution Program only at the participating clinic site or LHJ that requested the medication (medication ordered by LHJs for FDT can only be used for FDT). Medication from the CT/GC EPT Distribution Program may not be shared with other clinic sites or LHJs.
  • Patient education materials and a clinic referral must accompany all medication that is dispensed from the CT/GC EPT Distribution Program.
  • Designate one point-person to be responsible for ordering and management of medication from the CT/GC EPT Distribution Program. Only this person will be able to order medication and submit medication log data for all affiliated clinic sites and LHJs participating in the program. All CT/GC EPT Distribution Program communication from Essential Access Health will be directed to this person and other clinical staff may also be copied.
  • The point-person and all site contact(s) must watch the EPT webinar at least once, and again when an updated version is published and agree to be responsible for keeping all clinical staff informed about the appropriate uses of EPT. While not a requirement, Essential Access Health recommends that the medical director or physician overseeing EPT/PDPT dispensing practices also watch the webinar at least once, and again when an updated version is published. I confirm that all program terms and conditions have been met, including the requirement that the point-person (myself) and site contact(s) (applicable to agencies and LHJs with multiple participating sites) have watched the Essential Access Health EPT webinar at least one time within the past 12 months.
  • Keep a log of all dispensed medication doses from the CT/GC EPT Distribution Program at each participating clinic site or LHJ. Clinic sites and LHJs must be able to produce these medication logs at Essential Access Health's request.
  • If an order was not received, contact stdprograms@essentialaccess.org within 30 days of receipt of the shipment notification email from Essential Access Health. Essential Access Health assumes each clinic site or LHJ received their requested medication unless contacted to indicate otherwise.

Essential Access Health will follow up if there are any questions about information submitted on your registration form.

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