2021 -Hoboken COVID-19 - Testing Appointment Form

Hoboken COVID-19 - Testing Appointment

Hoboken Residents Only (Not for Riverside Patients)
Riverside Testing Location has moved to:

351 16th street
Between Grand and Clinton Street

Hoboken residents who are Riverside Medical Group patients should call their Riverside primary care office to schedule a COVID-19 test and should not use the online sign-up form.
- New Appointments will open every Wednesday for the following week. If appointments are greyed out the date is full.
- Rapid PCR tests are not recommended for asymptomatic individuals.
- Parents who are registering appointments for a child should register each child individually.
- Please do not book more than one appointment at a time. Multiple appointments will be canceled.
Appointments are available for Hoboken residents on a first-come, first-serve basis. Government identification or proof of address, along with insurance information should be provided when signing up for a test.

Riverside is offering both rapid, 15-minute COVID-19 tests as well as PCR testing. Proof of address is also required at the testing site.

Rapid 15 minute PCR Test - Abbott ID Now (Subject to availability)
Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Gender *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State

Zip Code
Drivers License/ Government Issued ID *
Patient Selection (You may select more than one option by holding the shift key) *
Business/School Name *
Other (Please Specify): *
Insurance Information *
If uninsured please select uninsured from the drop down list and skip to the symptom section below
Insurance ID# *
Group # *
Take a photo of your insurance card ( Front of Card) *
Take a photo of your insurance card ( Back of Card) *
Policy holder *
Policy holder name

First Name Last Name
Policy holder Date of Birth

Month Day Year
Date
Are you currently experiencing any symptoms? *

High fever Difficulty breathing Body aches Runny nose Diarrhea Cough Persistent pain or pressure in the chest Nasal congestion Sore throat None Loss of Taste or Smell
Please check if any apply:

I have symptoms of COVID-19 I have had close contact (within 6 feet of an infected person for at least 15 minutes in a 24 hour period)with someone with confirmed COVID-19). It is recommended to wait at least 5 to 7 days after exposure for testing. Why you Can't Test Out of COVID-19 Quarantine* https://www.nj.gov/health/cd/documents/topics/NCOV/COVID-Cannot-Test-Out-of-Quarantine.pdf I have traveled to a high-risk location I have been asked or referred to get testing by a healthcare provider, local or state health department.
Testing Method *

Drive-through with a vehicle Walk-in station
Appointment *
By submitting I hereby confirm that the information I have given above is true, and that I will comply with the terms and conditions outlined above.
Signature *

Clear
To cancel a scheduled COVID-19 test booked on this online system, please send an email to the Hoboken Health Department: LMedeiros@HobokenNJ.gov

For further information contact Riverside directly at (201)863-3346 or ccc@Riversidemedgroup.com
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