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 Name Last Name
Date of Birth *

Month Day Year
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 symptoms I have been exposed to COVID, and want a test I'm traveling and need a COVID test I'm having surgery and need a COVID test Other
Date of ONSET OF SYMPTOMS:

Month Day Year
Date
Symptoms (Please check all that applies)

Fever over 100.4F (38C) Felling Feverish Pain or difficulty swallowing Sore Throat Fatigue Muscle or body Ache Headache Cough Chills Nasal congestion Runny Nose Shortness of breath New loss of taste or smell Nausea Vomiting Diarrhea
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / 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