Big Trees MD Mobile Testing
Testing for Covid-19 (PCR and Antigen), Influenza and Streptococcus are available to Members and their family, friends and visiting guests! Please fill out the following information for EACH patient requesting testing and we will get back to you with regards to availability and scheduling! These tests are administered by Dr. Concepcion herself in the comfort of your home or a previously agreed location if distance, weather, etc are a factor.
PATIENT INFORMATION
Name
First Name
Last Name
Address where at home testing will take place.
Street Address
City
State / Province
Postal / Zip Code
When is the earliest you will available for testing at this address.
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Can you receive texts at this phone number?
Yes
No
Email
example@example.com
Birthdate
-
Month
-
Day
Year
Date
Have You Recently Traveled?
Yes
No
If you have travelled, where were you recently traveling within the past 30 days?
Have you had any of these symptoms in the last 14 days?
Cough
Diarrhea
Fever
Chills
Sore Throat
Fatigue
Vomiting
Nausea
Headache
Running Nose
Sense of Illness
Muscle Aches
Loss of Taste
None
Languages Spoken
English
Spanish
Other
Are you an enrolled MEMBER at Big Trees MD?
Yes
No
No, but I would like to be!
I do not know or I'm not sure
For Big Trees MD MEMBERS. what testing are you wanting? Mark all that apply.
Covid-19 Antigen ($40)
Covid-19 PCR mail away (can take 72+ hours for results) ($60)
Covid-19 Rapid PCR test (results in 30 minutes) ($135)
Influenza ($25)
Streptococcus ($0)
For NON-MEMBERS. what testing are you wanting? Mark all that apply.
Covid-19 Antigen ($90)
Covid-19 PCR mail away (can take 72+ hours for results) ($110)
Covid-19 Rapid PCR test (results in 30 minutes) ($195)
Influenza ($75)
Streptococcus ($50)
Submit
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