TotalCare COVID Test Refund Request
Please use this form to request a COVID test refund from TotalCare Walk-In Clinic. Please note that cancellations must be made at least 24 hours in advance to be eligible for a refund. Eligible requests will be processed in 7 days, and refunds may take an additional 5-10 business days to appear on your statement. Please email us at info@totalcarenow.com or call us a 909-591-8200 with any questions.
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Patient Name *
Patient Date of Birth *
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Patient email (the one used to book the test) *
Patient phone *
Appointment Date *
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YYYY
Appointment Time *
Time
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Reason for refund request *
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