Request an Appointment Form

New Appointment
Request an Appointment For:

COVID-19 Testing, Telehealth Services, & More!

COVID-19 Testing is by appointment only. We are not taking any walk-ins at this time. Schedule your appointment by completing the form below. We are doing everything we can to see as many people as safely possible. Thank you for your patience and understanding.

If you are going through insurance, please submit both the front and back of the card. At the beginning of the appointment, we will let you know if you have any copays for the service selected.

Note:
- COVID-19 PCR Test is $195 out of pocket
- COVID-19 Antibody Test is only out-of-pocket for $269.00
- Medi-cal, Kaiser, and other out of state insurances are NOT accepted for the COVID-19 testing.
- We currently don't take Medical or Calviva
****Special Announcements****

Appointments are only made on this page.

Please do not call to make an appointment.
Select a Reason *
Reason For The COVID-19 Test *
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number: *
E-mail *
DOB *
Date Of Birth (MM/DD/YY)
How would you like to pay? *
Insurance Card Photo: Front Side *

Browse Files
Front Side Cancel of
Insurance Card Photo: Back Side *

Browse Files
Back Side Cancel of
Are you a new patient? *

Yes No
Photo ID: Front Side *

Browse Files
Front Side Cancel of
Photo ID: Back Side *

Browse Files
Back Side Cancel of
Preferred Pharmacy (If Prescribed A Medication) *
Select an Appointment Date *
Terms & Conditions *

I understand that my time spot could be delayed due to unforeseen circumstances, but that Clovis Urgent Care does everything possible to accommodate my requested time spot. There may be a short wait when you arrive.
Should be Empty:

New Appointment