Free Home COVID Tests 
Aloha! 
Please fill out this form if you are interested in receiving FREE COVID 19 tests. Each family can receive up to 5 free COVID tests, but they are first-come first-serve until we run out. 

Tests will be sent home with your youngest child. 

Please contact us if you have any questions. haleiwaschool@haleiwa.k12.hi.us

Thank you, 
Mrs. Terada

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Person filling out form *
Name of YOUNGEST student at Hale'iwa *
Number of free COVID home tests you would like to receive: *
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