COVID-19 Test Result Enquiry
Email address *
Only use this request form if test was done at the Monroe Community COVID-19 Testing Site on Morton Street.
PLEASE NOTE

*No test results will be given automatically by submitting this request.
*No test results will be released verbally when contacted by a team member.
*Test results will only be released to the Patient that got tested, unless 17 years of age or younger to their legal Parent or Guardian (As per the registered contact information on file)
*Results can only be sent via Email, Fax or secured link via text (If available)
Patient First Name? *
Patient Last Name? *
Patient Date of Birth? *
MM
/
DD
/
YYYY
Patient Date Tested? *
MM
/
DD
/
YYYY
Contact Number? *
Relation to the Patient? *
Reason for this request? *
A copy of your responses will be emailed to the address you provided.
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