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Welcome to Super Health Pharmacy
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Select type of COVID-19 Test
*
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Your testing needs may be covered by your health insurance. Please call for details.
Rapid Covid-19 Antigen Test $25
Rapid Covid-19 PCR Nasal Swab Test $65 (Results within 15 minutes) Recommended for Travel, Medical Procedures, etc.
Rapid Flu A & B Test OR Rapid Strep A Test (Results within 15 minutes) $40
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Appointment For Rapid Flu A & B Test
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Appointment for Rapid COVID-19 Test
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One Appointment Per Person | Max one time slot PER patient
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Appointment
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Due to High Testing Demand, We do not allow appointment cancellations. Please verify with your end user if they will accept a RAPID COVID-19 Test as clearance, if this test is intended for such purpose. (i.e. work, travel, nursing home, hospital, etc.). By Submitting yes, you agree to our terms that Super Health Pharmacy will not be held responsible for any representations.
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YES
NO
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Date of Test
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Testing Starts At 10AM Daily!
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Date
Month
Day
Year
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8
Pharmacy Phone
For your reference
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Patient Name
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First Name
Last Name
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Middle Initial
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Date of Birth
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MM/DD/YYYY
Please make sure your birthday is in this format (MM/DD/YYYY) otherwise your registration might be rejected (ex. 12/01/99)
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Patient Address
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City
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State
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ZIP Code
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Race*
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Required By CDC
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Ethnicity*
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Required By CDC
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Cell Phone
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Gender
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Male
Female
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Are you Pregnant/Postpartum?
YES
NO
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21
COVID 19 (SARS CoV 2 Assay) via Nasal Swab
*
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COVID 19 (SARS CoV 2 Assay) via Nasal Swab
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22
ICD-10 Code
*
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Z20.828 Contact with and suspected exposure to other viral communicable disease
Z11.59 Asymptomatic, no known exposure, results unknown or negative
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23
Invoice ID
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24
Email *
Very important your email is accurate for testing instructions.
example@example.com
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25
Picture of Government Issued ID
Drivers License, Passport, Etc
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Select files to upload
Max. file size
: 10.6MB
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Secure Payment Portal
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My Bag
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Great Product Name
$20
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Great Product Name
$20
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Great Product Name
$20
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Great Product Name
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ORDER SUMMARY
Total cost
USD
Rapid COVID-19 TEST
Fastest way to get in and out is by paying online
$
120.00
+
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Rapid Antigen Test
Rapid PCR Test
Rapid Flu A & B or Rapid Strep
Insurance-If Covered
Rapid Antigen Test
Rapid Antigen Test
Rapid PCR Test
Rapid Flu A & B or Rapid Strep
Insurance-If Covered
Rapid COVID-19 Test
Credit Card (Paying online is the fastest & safest method)
First Name
Last Name
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27
Thank you. Stay Healthy and See You Soon!
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