• Covid-19 Testing Registration

  • For FREE lab-based PCR test (2+ days), please click on the link below to begin. 

    Covid-19 Antigen PCR lab-based test *NO COST TO YOU*

    **Every individual, including children, MUST be registered for their own account, in their own name. Otherwise, your test may not be processed. Save your user ID and Password created during registration! You will need this to get your test results once they are ready.**

    ********************************************************************************************************************************************************

    For Rapid Test options, please answer all questions below:

  • Personal Information for Rapid test(s) only:

  •  -  -
    Pick a Date
    • Insurance Info for "No Cost to You" Testing option only:  
    • Signature:  
    • This testing form uses eTrueNorth Laboratory and/or onsite's testing services to manage COVID-19 testing and reporting.  As a User accessing or using JotFrom (Application) provided by Pharmedico Pharmacy, you acknowledge and agree that you are solely responsible for and shall abide by these Terms of Service, as well as any relevant sections of Pharmedico’s Privacy Policies (collectively, Terms).

      Sign digitally with your mouse by clicking and dragging to form your signature.

    • Clear
    •  -  -
      Pick a Date
    • *By clicking the “Submit” button below, you certify that the above information is correct and accurate to the best of your knowledge. All information is confidential and is accessed only via a secure, encrypted interface.

    • Should be Empty:
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