Covid-19 Antigen Form

FAQs:

When is the Best Time to Get Tested After Exposure?

The CDC states that anyone who may have been exposed to someone with COVID should test five days after their exposure, or as soon as symptoms occur.

How long should you quarantine or isolate?

Those who have been within six feet of someone with COVID for a cumulative total of at least 15 minutes over a 24-hour period should quarantine for five days if unvaccinated, or if they are more than six months out from their second vaccine dose, according to updated CDC guidance. Once that period ends, they should partake in strict mask use for an additional five days.

Those who are both fully vaccinated and boosted do not need to quarantine if they are a close contact of someone with COVID, but should wear a mask for at least 10 days after exposure. The same goes for those who are fully vaccinated and not yet eligible for their booster shot.

What if you test positive using Rapid Antigen Test?
Positive test results should assume the test results are accurate and should isolate from others to reduce the risk of spreading the virus. Stay home and isolate for five days.

Test Site: Please stay in your car when you arrive at the pharmacy. Dial 334-230-7436 to inform the staff of your arrival.

iKARE PHARMACY 7212 Halcyon Park Drive, Montgomery, AL, 36117 Phone: 334-230-7436

What is Rapid Antigen Test? A rapid antigen test can be administered for individuals with or without COVID-19 symptoms. This test involves examining for protein fragments specific to the COVID-19 virus. While these tests provide quick results—within 15 minutes—they are generally not considered as accurate as PCR tests.

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

County*

Patient Phone Number*

Email*

example@example.com

Patient Date of Birth*

Date

Patient Age*

Race*

Sex

Ethnicity*

Date test ordered

Date

Appointment*

Pharmacist Performing Test

Date specimen collected

Signature of RPh Performing Test

Clear

Type of Test

Payment

Covid-19 Rapid Antigen TestCovid-19 Rapid Antigen Test.

$65.00

Total

$0.00

Credit Card

Consent (Must check ALL boxes in order to administer the test at the facility)

I authorize this COVID-19 Collection and testing through a nasal swab. I authorize that my test results be disclosed to the test administrator, county, state, or to any other governmental entity as may be required by law. I understand that this testing unit is not acting as my medical provider. I assume complete and full responsibility to take appropriate action with regards to my test results. I agree I will seek medical advice, care, and treatment from my medical provider if I have questions or concerns, or if my condition should worsen. I understand that as with any medical test, there is potential for false positive or false negative.I voluntarily agree to testing for COVID-19.I agree to pay the pharmacy by either Cash or Credit card prior to service

Accession # / Specimen ID

Result

PositiveNegative