I, {patientName}, am requesting to receive up to eight (8) tests per month.
By agreeing, you are authorizing Advanced Diagnostic Lab to be your preferred provider for eight (8) at-home COVID-19 tests each month for the duration of the Public Health Emergency (PHE). *
You acknowledge that insurers may cover up to 8 at-home COVID-19 tests per person each calendar month. Requests exceeding this amount may be billed directly to the patient.