Covid-19/FLU ANTIGEN TEST

Covid-19/FLU A&B ANTIGEN TEST

Our Rapid COVID-19/Flu A&B Antigen Test is for sick patients. It will tell you if you have COVID or the FLU. Nasal swab inserted 1" with 15-minute results.
PLEASE BRING YOUR DRIVER LICENSE or PASSPORT. (Our application allows us to populate the information by scanning one of these identification)

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
Appointment
Name as it appears on Passport or Driver License*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender
Race
Ethnicity
Please select the best option (Please stay in your car and call us if you have symptoms):

I have cold/flu like symptomsI have been exposed to COVID, and want a testI'm traveling and need a COVID testI'm having surgery and need a COVID testOther
Date of ONSET OF SYMPTOMS:

MonthDayYear
Date
Symptoms (Please check all that applies)

Fever over 100.4F (38C)Felling FeverishPain or difficulty swallowingSore ThroatFatigueMuscle or body AcheHeadacheCoughChillsNasal congestionRunny NoseShortness of breathNew loss of taste or smellNauseaVomitingDiarrhea
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Select Identification *
What is your Driver License # or Passport No.*

COVID-19/FLU A&B ANTIGEN TEST

$99.00

Total

$0.00

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/FLU.I agree to pay the pharmacy by either Cash or Credit card prior to service
Should be Empty:

Covid-19/FLU A&B ANTIGEN TEST