WISE (Wellness, Inclusion, Support, and Empowerment) HIV and Aging Group Interest Form

This interest survey is for our cohort beginning Tuesday, September 22nd, 2026. Thank you for your interest in WISE, Mazzoni Center's group for folks over 65 living with HIV! Please fill out the survey below and we will be in contact soon.
1.Please enter your contact information so we can reach out to you. We primarily communicate via Email.
We will not share this information.
(Required.)
2.Are you HIV+?
**This group is for folks living with HIV**
(Required.)
3.Are you based in Philadelphia or the surrounding area?
**This group meets in person in Philadelphia**
(Required.)
4.Where did you hear about this group?(Required.)
5.Why are you interested in joining this group? What are you hoping to gain?(Required.)
6.Are you 65 or older? (you must be 65 or older to join this program)
7.Do you have access to transportation to get to Center City?(Required.)
8.Anything else you would like to share or questions you have?
Current Progress,
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