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Name
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First Name
Last Name
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Email
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Phone Number
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Birthdate
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Appointment
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ORDER SUMMARY
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PCR Test for COVID-19 or COVID-19/FluA/FluB/RSV plus (Cepheid GeneXpert Infinity)
COVID-19 or 4-Plex with COVID/FLU/RSV available. COVID only testing is recommended for travel and is arranged at the time of testing. RT-PCR is the most accurate test for respiratory illness. PCR is often needed for international travel or return to work. Testing is done on-site, and process time is 40 minutes with results to your email in 1 hr. This test is considered NAAT.
$
249.00
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Rapid Antigen Test for COVID-19- COVID Screening (Quidel Sofia 2 or LumiraDX)
Rapid antigen testing for COVID-19 is often helpful when seasonal respiratory illness is present. Testing is done on-site, and process time is 15 minutes with results within an hour. This test is considered antigen testing but is not PCR or NAAT.
$
79.00
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Rapid Antigen Test for COVID-19 + Flu A/B (Quidel Sofia 2)
Rapid antigen testing for COVID-19 and Influenza is often helpful when seasonal respiratory illness is present. Testing is done on-site, and process time is 15 minutes with results within an hour. This test is considered antigen testing for both viruses but is not PCR or NAAT.
$
149.00
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Rapid Antigen Test for Group A Strep- Strep Throat Screening (Quidel Sofia 2)
Rapid antigen testing for Group A Streptococcus. This is what causes strep throat. Testing is done on-site, and process time is 15 minutes with results within an hour.
$
79.00
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Rapid Antigen Test for Flu A/B- Flu Screening (Quidel Sofia 2)
Rapid antigen testing for Influenza A/B. Testing is done on-site, and process time is 15 minutes with results within an hour. This test is considered antigen testing for Influenza only and is not PCR or NAAT.
$
75.00
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Relationship Wellness Panel- STD Screening
Urine RT-PCR testing for sexually transmitted infections. Urine test for Gonorrhea, Chlamydia, and Trichomonas. Discrete testing with results to your email in 1 hour.
$
329.00
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Urine Drug Screen- Screening for Drugs of Abuse
Urine Drug Screening for employment and personal needs. All tests have adulterant screening that will need to be passed and any positive test is recommended to have confirmation testing at a reference lab.
$
99.00
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Urinalysis- UTI Screening
Urinalysis is a rapid screen for simple urinary tract infections or UTI. Results are available within the hour and positive results will be reviewed by our physician for possible treatment options.
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39.00
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Physician Note For Travel/Work/School
For our tested patients, our physicians can provide fit to fly, return to work, or return to school notes.
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After submitting the form, you will be redirected to the Apple Pay to complete the payment.
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7
Address
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Your address is needed for mandatory reporting of results.
Street Address
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State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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8
Do you currently have symptoms concerning for COVID-19?
YES
NO
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9
When did you begin to have symptoms?
Makes sure to wear a mask for your testing appointment!
-
Date
Month
Day
Year
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10
Telehealth Terms and Conditions
American Testing Solutions, LLC (ATS) offers telehealth services for positive test results. This service is offered to qualified patients that have a positive test result done at American Testing Solutions. By clicking below, you agree to being contacted by ATS for a confidential health questionnaire. You may, also, be contacted by a physician to review your history, medications, and result. ATS offers telehealth services as a convenience to our patients at a small surcharge that will be collected only if these services are needed and/or agreed to after your positive test has been reviewed. You are not obligated to use the telehealth services by getting tested at ATS. By agreeing below you understand that this service is not intended to replace the healthcare by your primary healthcare provider. Any change to your condition, worsening, or concern will need to be evaluated immediately by calling 911 or by contacting your primary care provider or by going to your closest emergency room.
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11
Are you traveling?
YES
NO
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12
Travel Terms and Conditions
*
This field is required.
Travel requirements change frequently. Individual travel requirements are the sole responsibility of the traveler. American Testing Solutions, LLC will provide requested results within the capability of our systems. American Testing Solutions, LLC, however, is not responsible for any travel complications related to the requested test. Some travel systems require the uploading of travel documents or the use of QR codes. By checking below, the traveler understands that private health information will be stored on cloud based storage systems to meet the travel requirements of some countries at the traveler's request.
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13
Please Review
Please review and will be prompted to sign when you click NEXT
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14
Consent Agreement
*
This field is required.
By signing you agree to the terms of the testing and sale. If the patient is under 18 years old, a parent or legal guardian will need to sign. Please bring a photo ID to your appointment for confirmation.
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15
Date & Time Collected
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Age
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19
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