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HealthHIV Learning Management System
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Username
Only lowercase letters allowed (Capital letters not allowed)
Password
Email address
Primary Email Address Type
Personal
Business
Secondary Email Address
First name
Last name
Preferred Pronouns
Department
Organization or Company
Principal Employment/Practice Setting
Choose...
Academic Health Center
Administrative Facility
Advocacy Organization
AIDS Service Organization (ASO)
Capacity Building Partner
College/University
Community-Based/Retail Pharmacy
Community-Based Organization (CBO)
Correctional Facility/Institution
Faith-Based Organization (FBO)
Health Center (e.g., Federally Qualified Health Center, FQHC Look-Alike)
Health Clinic
Health Services Facility
Health Maintenance Organization/Managed Care Organization
Hospital/Hospital-Affiliated Clinic
Indian Health Services
Local Health Department
Military Health System/Veteran’s Health
Non-Profit Organization
Pharmaceutical Manufacturer
Private Practice (Solo/Group)
Rural Health Center
Social Service Organization
State Health Department
Third-Party Payor
Not Affiliated with an Organization
Other
Principal Employment/Practice Setting - Other
Job Title
Degree(s)
Primary Function/Profession
Choose...
Administrator
Advocate
Case Management
Clergy/Faith-based Professional
Community Health Worker
Dentist
Dietician/Nutritionist
Disease Intervention Specialist
Finance/Fiscal Manager
Harm Reductionist/Risk Reductionist
Health Education Specialist
Health Navigator
Licensed Practical Nurse
Medical Assistant
Medical billing
Mental Health Case Manager
Mental Health Professional
Nurse Practitioner
Nursing Case Manager
Occupational therapist
Outreach Worker
Patient/Consumer
Pharmacist
Pharmacy Technician
Psychologist
Physician Assistant
Physician
Registered Nurse
Researcher
Social Worker
Student
Substance Abuse Counselor/ Professional
Other Provider/Professional
Primary Function/Profession - Other
Primary Area of Specialization/Focus
Choose...
Addiction Medicine
Allergy and clinical immunology
Cardiology
Critical care/ intensive care
Dentistry
Dermatology
Diabetes
Emergency medicine
Endocrinology
Family medicine
Gastroenterology
General practice
Geriatrics
Hematology
Hepatology
HIV/AIDS
Hospice/palliative care
Infectious Diseases
Internal Medicine
Neonatal/Perinatal Medicine
Nephrology
Neurology
Neurosurgery
Nutrition
OB/GYN and Women’s Health
Oncology
Ophthalmology
Otolaryngology
Pain Management
Pathology
Pediatrics
Preventative medicine
Psychiatry
Psychology
public/community health
Pulmonary medicine
Radiology
Rheumatology
Sleep medicine
Sports Medicine
Surgery
Transplantation
Urology
Vascular medicine
Other
Primary Area of Specialization/Focus - Other
Continued Education Credits
Choose...
Yes
No
Continuing Education Credit Type
American Medical Association (MDs, DOs)
American Medical Association (NPs, PAs)
American Academy of Physician Assistants (PAs)
Accreditation Council for Pharmacy Education (Pharmacists)
American Nurses Credentialing Center (Registered Nurses)
American Psychological Association (Psychologists)
Association of Social Work Boards (ASWB)
Certificated Health Education Specialists Credits/Master Certified Health Education Specialist (CHES/MCHES)
Certified Public Health Recertification (CPH)
None
ABIM#
CHES/MCHES#
NABP#
NBPHE#
NPI#
RLN#
Other License Number
Birth Month
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01
02
03
04
05
06
07
08
09
10
11
12
Birth Day
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01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Initial License Year
Choose...
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Country
Choose...
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (the Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (the Democratic People's Republic of)
Korea (the Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (the Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
City/town
Business Phone
Business Address 1
Business Address 2
Business City
Business State, Province or Territory
Choose...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
United States Minor Outlying Islands
Virgin Islands, U.S.
State(s) Licensed
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
American Samoa
Guam
Northern Mariana Islands
Puerto Rico
United States Minor Outlying Islands
Virgin Islands, U.S.
DC Ward
Ward 1
Ward 2
Ward 3
Ward 4
Ward 5
Ward 6
Ward 7
Ward 8
Postal Code
Birth Year
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Gender Identity
Choose...
Agender
Androgyne
Demigender
Genderqueer/ Gender fluid
Man
Questioning/Unsure
Trans man
Trans woman
Woman
Other
Racial Background
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Other
Origin
Yes
No
Spoken Languages
Amharic, Somali, or other Afro-Asiatic languages
Arabic
Armenian
Chinese
Creole
English
French
German
Greek
Gujarati
Haitian
Hebrew
Hindi
Hmong
Ilocano, Samoan, Hawaiian, or other Austronesian languages
Italian
Japanese
Khmer
Korean
Malayalam, Kannada, or other Dravidian languages
Nepali, Marathi, or other Indic languages
Persian
Polish
Portuguese
Punjabi
Russian
Serbo-Croatian
Spanish
Swahili other languages of Central, Eastern, and Southern Africa
Tagalog
Tamil
Telugu
Thai, Lao, other Tai-Kadai languages
Ukrainian or other Slavic languages
Urdu
Vietnamese
Yiddish, Pennsylvania Dutch or other West Germanic Languages
Yoruba, Twi, Igbo, or other languages of Western Africa
Other Asian languages
Other Indo-European languages
Other
Graduation Year
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
Employment Status
Full-Time (32 hours or more hours per week)
Part-Time (less than 32)
Unemployed and looking for work
Unemployed and NOT looking for work
Contractor/Consultant
Student
Retired
Homemaker
Disabled, not able to work
Other
Prefer not to answer
Gender Identity - Other
Employment Status - Other
Racial Background - Other
Spoken Languages - Other
Are you a licensed provider?
Choose...
I am not a licensed provider
Acupuncturist
Certified Addiction Counselor
Chiropractor
CNS
DDS
Dietitian
DO
LCSW
LPC
LPN
Massage Therapist
MD
Mental Health Counselor
NP
Nutritionist
PA
Pharm Tech
PharmD
Podiatrist
Psychologist
Resident/Fellow
RN
Substance Abuse Counselor
Other
Licensed Provider Other
Highest Degree Earned
Choose...
AS/AAS
BA/BS
MA/MS
MPH
MD
PhD/EdD
DrPH
ScD
PharmD
DDS
DO
Not Applicable/No Degree
Degree(s)/Credentials
Initial License Year
Choose...
Choose...
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
NA
What percentage of your time is devoted to each of the following areas?
Percentage of Time Spent in Patient Care
Percentage of Time Spent in Research
Percentage of Time Spent in Teaching/Instruction
Percentage of Time Spent in Administration
Security question
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