Rapid COVID-19 Testing

Rapid COVID-19 Testing

The BD Veritor™ System Rapid Detection of SARS-CoV-2 & Flu A+B is a rapid antigen test that includes a simple nasal swab inside the opening of the nose. It gives results in 15 minutes and costs $125 per test. We are not able to bill insurance at this time, but you may be able to submit for reimbursement.
Name *

First Name Last Name
Birth Date *

Month Day Year
Date
Gender *

Female Male
Email
example@example.com
Phone Number *
Please enter a valid phone number.
Address *

Street Address

Apt or Suite

City State / Province

Postal / Zip Code
County of Residence *
Race *

American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or Other Pacific Islander White Other
Ethnicity *

Hispanic or Latino Not Hispanic or Latino Unknown Decline to state
CDC Questions
Is this your first COVID test? *

Yes No Unsure
Are you having any symptoms of COVID-19, including but not limited to: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea? *

Yes No Unsure
If yes, please select the date when these symptoms started

Month Day Year
Date
Do you work in healthcare? *

Yes No Unsure
Do you live in congregate care setting (including nursing homes, residential care for people with intellectual and developmental disabilities, psychiatric treatment facilities, group homes, board and care homes, homeless shelter, foster care or other setting)? *

Yes No Unsure
Are you pregnant? *

Yes No Unsure
Appointment *
Vehicle Description *
Color, make, and model
CONSENT AND RELEASE

To agree to participate in this test, please review the above fact sheet and below bullets. Please provide the participant signature below indicating that the participant has read and understands these terms.

- I have read and understand the “Fact Sheet for Patients” provided to me
- In consideration of my participation in this test, I hereby agree to assume all risks. I also understand the results are not designed to replace the care or advice of a medical provider. I understand that if I receive abnormal laboratory test results, I should promptly consult with a medical provider.
- This test will not be billed to your insurance by HealthRidge Pharmacy. If requested, you will receive a receipt and invoice after testing to submit to insurance. Coverage is not guaranteed. Your insurance may reimburse the full amount, a portion of the amount, or none at all.
Signature *

Clear
Payment

This test costs $125 and will NOT be billed to your insurance by the pharmacy. Credit card information will be taken over the phone prior to test administration.
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Rapid COVID-19 Testing

CDC Questions

Payment