On Site Testing (James St.)

First Name

Last Name

Company (if applicable)

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Your email

Phone Number

Date of Birth

Please use format: MM/DD/YYYY (Including forward slash /)

Gender
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Race
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Ethnicity
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Symptoms/Exposure
—Please choose an option—I don't know if I was exposed to COVID-19 and I don't have symptoms.I don't know if I was exposed to COVID-19 but I have symptoms.I was exposed to COVID-19 but I don't have any symptoms.I was exposed to COVID and I have symptoms.

Test Requested
—Please choose an option—Rapid Antigen TestLab PCR TestSaliva TestAntibody TestAditxtScore-COVID-19 Immunity Test

Testing Location
—Please choose an option—Appointment LaneBay 1Bay 2Bay 3Remote Testing