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.
PLEASE CALL FROM YOUR CAR WHEN YOU ARRIVE FOR FURTHER INSTRUCTIONS
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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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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