Rapid Antigen Test Kit Order Form
The form below can be used for both your first order and refill orders of rapid antigen test kits. Please note that there are both training and reporting requirements for participation in this program.
Business Name *
Contact Name *
Email Address *
Telephone Number *
Number of Employees (2 week supply provided based on 2 tests/week per employee) *
Please Note: If you are ordering refills, you MUST have reported your results as per the Provincial Antigen Screening Program Agreement. We will not refill orders unless you have reported the results for 75% of the screening kits that you picked up.
Rapid Antigen Test Kit Order Form *
Attestation
Your Screening Supervisor Designate is required to watch the 5-minute instructional video below before your first pickup. This video demonstrates how to properly conducting the self screening, and can be shared with all your employees. You will be required to make an attestation below that your Designate has watched the video.
Training Video
*
Required
Optional Video
Submit
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