Dr. R.E. Margo Elementary's COVID-19 Self-Administered Test

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We are offering a self-administered nasal swab test that allows those being tested to swab their own nose onsite, observed by a trained staff member to ensure the sample is taken correctly.

Once test has been administered you will be asked to wait in a designated area for 15 minutes until we obtain the results.

This is on a voluntarily basis. It is NOT mandatory.
(This is ONLY a screening tool and NOT a diagnostic exam)

Email *

Dr. R.E. Margo Elementary Screening Registration Form

Please fill out the following information

First Name: *

Last Name: *

Employee ID: *

Please Provide a cellphone number for testing results. (Ex: (956)555-5555) *

Do you have any of the following symptoms? Cough, headache, fever, fatigue, nausea, vomiting, diarrhea, shortness of breath, chills, sore throat, loss of taste/smell, congestion/ runny nose, signification muscle pain/ache, and/or difficulty breathing: *

Yes

Do you agree to obtain your own specimen collection by self-swabbing? *

Yes

Have you tested positive within the last three months?(No onsite screening is recommended for individuals who have tested positive within that time frame. If symptoms arise please seek medical attention with your primary Doctor) *

Yes

If your screening results are positive, do you agree to seek medical attention? *

Yes

I hereby certify that the above statements are true and correct to the best of my knowledge *

Yes

If you have any questions, please contact your campus nurse or administration.

(956)969-6800

Send me a copy of my responses.

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