34|Tarrytown Central POCT

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Point-of-Care Testing Appointment Booking

Tarrytown Pharmacy • 2727 Exposition Blvd. Ste. 105 • Austin, TX 78703
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product Name

COVID-19 Rapid Antigen (#515)COVID-19 Rapid Antibody (#516)COVID-19 Rapid Molecular (#517)Flu Test (#518)Strep Test (#519)Flu/COVID Antigen Combo (#520)Covid 19 RT-PCR Rapid (#521)RSV Test (#522)Rapid Flu + COVID Molecular NAAT (#523)Rapid Flu + COVID RT-PCR (#524)COVID PCR Home Test (#525)
All fields marked with * are required and must be filled.
NO REFUNDS or RETURNS on Point of Care Testing Appointments relating to FDA EUA Approved COVID-19 Test

Appointment (General)*
Appointment (NAAT)*
Appointment (RT-PCR)*
Appointment (Strep)*
Partial day, holiday closure placeholder.
NOTICE

After Hours testing is available

Monday & Wednesday: 6pm-8pm

Tuesday, Thursday, Friday: 4pm-8 pm

Saturday: 5pm-6pm

Please call 512-478-6419, Option 4, to set up an appointment with a staff member.
Active Appointment

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Date
Hour Minutes
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Hour Minutes
timezone
Test-Specific Notices
Notice for Rapid RT-PCR Test *PLEASE READ**

*Please adhere to the appointment time selected* Due to the time-sensitive nature of this test, we are unable to accommodate patients who are early or late to their selected appointment time to ensure that other patients' results are not delayed. There will be a $30 charge for changing appointment times.
Notice for Antibody Tests:*

This test requires a finger-prick and a small sample of blood. The results are qualitative provided as either positive or negative for IgG or IgM antibodies for both the S and N proteins of the SARS-CoV-2 virus. This test will not provide a quantity of antibodies present. This test will not determine if you have an active COVID-19 infection. It will only show if any antibodies are present from a past COVID-19 infection or if you are vaccinated. However, a positive antibody test will not differentiate between a past COVID-19 infection or vaccination status.
Notice for Strep Rapid Test*

This test is for informational purposes only. At this time we are unable to guarantee a prescription to treat infection with Group A Strep.
Notice and Consent for Saliva PCR Tests:*

Do not eat or drink, smoke, or chew gum for 30-minutes before collecting this saliva sample. You must follow instructions enclosed in your test kit. Failing to do so could invalidate or provide inconclusive results. Upon purchase of this test, I hereby consent for Tarrytown Pharmacy staff to register my test kit to Genotox Laboratories for my TruthTest Saliva PCR test. I understand that my sample will be anonymously analyzed by a third-party laboratory for processing and notification of results. I agree to indemnify and hold harmless Tarrytown Pharmacy, their affiliates, mangers, members, and staff from any and all liability associated with this test.
Anticipated Sample Collection Date for At-Home Saliva PCR Test*

MonthDayYear
Date

Patient Information
Are you a Parent/Guardian purchasing a test appointment for a minor?*

YesNo

Guardian Information
Parent/Guardian Name*

First NameMiddle NameLast Name
Parent/Guardian Email*
Please provide the email address where you would like to receive notification. (Check your Spam folder) example@example.com.
Parent/Guardian Mobile Phone Number*
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Parent/Guardian Address*

Street Address

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Parent/Guardian County of Residence*
County (not Country), example: Travis County
Parent/Guardian Date of Birth*

MonthDayYear
Please call us if you are booking for a child less than 5 years old at (512) 229-0447
Parent/Guardian Gender*

MaleFemale

Consent for Testing
By booking this appointment, I understand and agree:
- I am consenting to receive a point-of-care test with Pharmacy.
- No test is 100% accurate, and there is a chance that the results of the test may or may not accurately reflect my diagnostic status.
- I do not hold Pharmacy or any employee or other representative of Tarrytown Pharmacy responsible for any consequence of a positive, negative, or inconclusive result.
- Due to the nature of point-of-care testing, there is a risk that I may be exposed to or infected by proceeding with my scheduled testing and hereby fully assume all risks which include without limitation, the need for additional testing, a positive diagnosis, required quarantine or self-isolation, hospitalization, treatment in an intesive care unit and intubation or ventilation support, death, and/or other medical complications.
- Pharmacy may have an obligation to report test results to governmental or other public health authorities pursuant to applicable law and regulations and I hereby consent to any such reporting by Pharmacy.
- I acknowledge and agree to having my test results sent to me via text message. And also over email, if I request the official PDF result. I understand that this is considered Protected Health Information (PHI), and authorize Pharmacy to send it.
- In the event that my employer pays (whether directly or indirectly) for my test, then I hereby consent to Pharmacy disclosing the results of my test to my employer.
- Under no circumstance am I entitled to a refund.
- I am expected to arrive on-time to my appointment.
- If I am late or miss my appointment, I understand that my test may not be rescheduled and I am not entitled to a refund.
- I understand that Pharmacy does not bill medical insurances for COVID tests. This is an out-of-pocket cost.
- I understand that if I choose to submit a claim to my insurance, reimbursement is not guaranteed.
Signature

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Please verify that you are human*
Having trouble booking?

Give our testing department a call at (512) 229-0447 (option 1)

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Hidden Pharmacy Information

Point-of-Care Testing Appointment Booking

Test-Specific Notices

Patient Information

Guardian Information

Patient Information

Consent for Testing