Doctor's Choice Pharmacy
COVID-19 Rapid Antigen Test Appointment
COVID-19 tests, 1 hour, $95 each (Credit/Debit Card Only)
IMPORTANT INFORMATION:
Rapid Antigen Test (Neg: 90%, Positive: 99% accurate)
This is NOT a PCR test required for travelling
Used for Healthcare workers and other workplace to get back to work.
DRIVE-UP ONLY. PLEASE CALL FROM YOUR CAR WHEN YOU ARRIVE.
Self Swab (we only collect samples and analyze)
Cancellation/Reschedule: $25 Fee
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Have you had direct contact with someone who is confirmed to have COVID-19 within the past 14 days?
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Yes
No
Do you have any Symptoms?
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Yes
No
Do you have a cough, runny nose, sore throat, or congestion?
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Yes
No
Date of onset
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Month
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Year
Date
Do you have difficulty breathing or shortness of breath?
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Hospitalization
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Yes
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Do you have a loss of taste or smell?
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Yes
No
Do you have abdominal pain, diarrhea, nausea, or vomiting?
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Yes
No
Do you have chills or fever of over 100 degrees?
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Yes
No
Pre-existing Medical Conditions: select all that apply
Pregnancy
Diabetes
Hypertension
Cardiovascular Disease
Chronic Pulmonary Disease
Asthma
Chronic Renal Disease
Chronic Liver Disease
Immunocompromised
Neurologic Disability
None
Other
Informed Consent for COVID-19 Testing
I understand that Doctor's Choice Pharmacy is not acting as my medical provider. Testing does not replace treatment by my medical provider. I assume complete responsibility to take appropriate action with regards to my test results. I agree I will seek medical advice if needed. I also understand the potential for false positive or false negative test. I voluntarily agree to testing for COVID-19.
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COVID Antigen Test
$
95.00
15 Minute Rapid Antigen Test
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