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Grand Care Pharmacy COVID-19 Testing Form Updated 09/2021
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    You will also have the option to do the free test with the rapid test at the end of the form. Medicaid Patients may be eligible to rapid test for free of charge. Call us for details.
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    One Appointment Per Person | Max one time slot PER patient
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    Please call the pharmacy for any last minute openings.
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    New 5 Minute Intervals. One appointment per person.
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    Testing Starts At 10AM Daily!
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    Pick a Date
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    For your reference
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    MM/DD/YYYY
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    Required By CDC
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    Required By CDC
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    Name of Insurance Company
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    Very important your email is accurate for testing instructions.
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    Drivers License, Passport, Etc
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
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    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
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    Payment is nonrefundable; We will provide an itemized receipt if you would like to submit this to your insurance for possible reimbursement. SELECT YOUR OPTION FROM THE DROP DOWN (Rapid PCR-$225, Rapid Antigen-$65, or Pay In Person)
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      ORDER SUMMARY
      Total costUSD
      • Rapid COVID-19 TESTFastest way to get in and out is by paying online
        $120.00+Edit
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        Rapid Antigen Test
        • Rapid Antigen Test
        • Rapid PCR Test
        • Medicaid-Free
        • Rapid Antibody Test
        • Rapid Influenza A & B
        Subtotal: $0.00
        Total cost $0.00
        Credit Card (If paying IN person, simply click submit) Paying Online is the fastest method!
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        Results within 2-3 days
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        You will now be redirected to Infinity Diagnostic Labs Portal. You must register with the lab in order to get the Free PCR Test. Results will take 2-3 days. You may need to use different email addresses for different patients. Please provide the confirmation number you get from the lab via email when you arrive at the pharmacy.

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