COVID 19 Home Test Request Form

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By completing this form, you are requesting COVID 19 Home Test Kits from the Union County Health Department.
Test kits are available for pick up from 8:30am to 4:00pm Monday through Friday. The address is 940 London Ave. Orders can be picked up in the Health Department Administration Lobby (enter the main entrance, go to the hallway on the right, and enter the first Health Dept doors).
We will hold orders for a 24 hour period and then those test kits will be put back into circulation for distribution.
There is a limit of 4 test kits per household.
One person may pick up for multiple households.
If you are symptomatic, we ask that you stay in your car and call 937-642-2053 and someone will bring the kits out to you.
If you have any questions or problems, please call our office at 937-642-2053. Thank you, Union County Health Department
Thank you,
Union County Health Department

Email *

First name *

Last name *

Last 4 digits of your phone number *

Number of test kits needed *

Currently, UCHD is out of proctored tests. Proctored test like BINAX NOW will provide verified results. (Most often verified results are required for attendance at events like concerts, return to sports/work, or travel.) *

Yes, I understand by checking this box I am reserving a non-proctored test.

Send me a copy of my responses.

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