COVID-19 Testing Pre-Registration
Preinscripción COVID19

Thank you for pre-registering for free public COVID-19 testing. Once you have completed the form below we will have your COVID-19 testing documentation printed and ready for review upon arrival. When you arrive at the testing facility please look for and proceed to the “pre-registered” lane. Although you selected an estimated arrival time during pre-registration, we will gladly perform the testing at any time. All personal information provided during the pre-registration process will be properly secured and safeguarded in accordance with Federal HIPAA regulations.

NOTE: This form needs to be completed for each person expecting to be tested.
Email Address
Dirección de correo electrónico
Sampling Date *
Please select the testing date and location. (Fecha de muestreo. Seleccione la fecha y la ubicación de la prueba)
Sampling Time
Please enter the estimated time you might arrive for testing on the above sampling date. (Tiempo de muestreo. Indique la hora estimada a la que podría llegar para realizar las pruebas en la fecha de muestreo anterior)
Time
:
Minor Child *
Menor
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