At-Home COVID TEST REQUEST FORM
Please fill out the form in it's entirety. Please note that if we do not have your current insurance on file we may not be able to successfully process the tests and due to the high volume of requests will not be able to reach out to gather that information. If you believe your insurance has changed please bring that information with you when you come to pickup your tests. We will dispense iHealth or FlowFlex tests based on availability.