12/18 Cumberland City COVID Testing Sign-ups

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Rescheduled to 12/18/20 for Inclement Weather Forecasted on Wednesday!

Please complete all required fields to sign up for COVID Testing. This drive is planned to be inside. If you would like to have your test done in your vehicle, please email Bri (blavorgna@aeontechlabs.com) directly to set up accommodations.

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City of Cumberland Business Name *

Business Phone Number *

First Name *

Last Name *

Phone Number - Please make sure this is a working number - this number will be used to report all POSITIVE results. (Note - for minors, please use parent/guardian's phone number) *

Date of Birth (Day, Month, Year) *

Gender *

Female

Male

Street Address *

City *

State *

Zip Code *

Ethnicity *

Hispanic

Not Hispanic

Unknown

Result Preference: Please either provide your cell or email for receiving a text for negative results. All positives will be a phone call. *

Have you tested positive in the past 90 days? *

Yes

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