VIVE x Eden Health / Appointment Booking Form
Eden Health will operate an onsite clinic for the conference attendees on March 7th and 8th  from 10am to 6.30pm and on March 11 from 10am to 1pm. Please fill the information below to book an appointment:
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Email *
First Name *
Last Name *
Date of Birth *
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Sex *
Country *
State (optional)
Phone Number *
What type of appointment would you like to book? *
*COVID-19 rapid antigen tests and biometric screenings are provided to all attendees free of charge. To receive a PCR COVID-19 test, you must have an active health insurance policy in the United States. Attendees without an active, U.S.-based health insurance policy who are interested in receiving a PCR COVID-19 test will incur a $100 fee. Allow 48hrs for results
Company Name
Job Title
Do you accept our Terms of Service? *
Do you accept our Privacy Policy? *
Do you accept the HIPAA Statement and Notice of Eden Health Privacy Practices? *
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