COVID-19 Antigen Test Inquiry Form
PLEASE READ.

WA DOH announced that the local health jurisdiction (LHJ) test ordering portal will be discontinued at the end of this month (January). Consequently, LHJs will no longer be able to request tests as before. This change means that community partners will need to procure their own testing supplies independently, whether through pharmacies, vendors, or online sources.

You can still submit test requests while supplies are available. While we will make every effort to fulfill orders for testing supplies, please be aware that it is not guaranteed tests will be distributed to your organization. Our first priority is with vulnerable, at risk and under-resourced populations and those who work with them. If we have tests available to allocate to your organization, we'll reach out to you via your preferred contact method.

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Your name *
Phone number *
E-mail *
Preferred contact method *
Required
What organization do you represent? *
What is your organization's address? *
What population does your organization serve? *
What geographic area(s) in Whatcom does your organization serve? *
Approximately how many clients do you serve a week?
Do the clients you serve live in a congregate setting or have shared living spaces? *
Who will you be giving these test to? *
Required
How many tests are you interested in receiving?
Do you have a secure, temperature-controlled location you can store tests?
Clear selection
Are you, or another representative, able to pick up tests in Bellingham? *
For facilities performing the tests, does your organization have a CLIA waiver (Medical Test site license)? 
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