You can always press Enter⏎ to continue
Welcome to Super Health Pharmacy
Hi there, please fill out and submit this form. 
  • 1
    Press
    Enter
  • 2
    Your testing needs may be covered by your health insurance. Please call for details.
    Press
    Enter
  • 3
    Press
    Enter
  • 4
    One Appointment Per Person | Max one time slot PER patient
    Press
    Enter
  • 5
    Press
    Enter
  • 6
    Press
    Enter
  • 7
    Testing Starts At 10AM Daily!
    /
    Pick a Date
    Press
    Enter
  • 8
    For your reference
    Press
    Enter
  • 9
    Press
    Enter
  • 10
    Press
    Enter
  • 11
    MM/DD/YYYY
    Press
    Enter
  • 12
    Press
    Enter
  • 13
    Press
    Enter
  • 14
    Press
    Enter
  • 15
    Press
    Enter
  • 16
    Required By CDC
    Press
    Enter
  • 17
    Required By CDC
    Press
    Enter
  • 18
    Press
    Enter
  • 19
    Press
    Enter
  • 20
    Press
    Enter
  • 21
    Press
    Enter
  • 22
    Press
    Enter
  • 23
    Press
    Enter
  • 24
    Very important your email is accurate for testing instructions.
    Press
    Enter
  • 25
    Drivers License, Passport, Etc
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
    Cancelof
    Press
    Enter
  • 26
    Please select from the drop down
    prevnext( X )
      My Bag
      1
      My Bag
      Great Product Name
      $20
      Quantity:1
      Size:Small
      RemoveEdit
      Great Product Name
      $20
      Quantity:1
      Size:Small
      RemoveEdit
      Great Product Name
      $20
      Quantity:1
      Size:Small
      RemoveEdit
      Great Product Name
      $20
      Quantity:1
      Size:Small
      RemoveEdit
      ORDER SUMMARY
      Total costUSD
      • Rapid COVID-19 TESTFastest way to get in and out is by paying online
        $120.00+Edit
        Back

        Rapid Antigen Test
        • Rapid Antigen Test
        • Rapid PCR Test
        • Rapid Flu A & B or Rapid Strep
        • Insurance-If Covered
        Subtotal: $0.00
        Total cost $0.00
        Credit Card (Paying online is the fastest & safest method)
        Press
        Enter
      • 27

        Thank you. Stay Healthy and See You Soon!

        Press
        Enter
      • Should be Empty:
      hipaa badge
      Question Label
      1 of 27See AllGo Back
      close