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Health Checklist /Test Scheduling
Please fill out the below in order to schedule your test. If there are any “yes” answers we will reschedule your testing session.
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Email
*
Your email
Enter your first/last name:
*
Your answer
Do you presently have any of these symptoms? Select all that apply.
*
Fever
Chills
Repeated shaking with chills
Muscle pain
Headache
New loss of taste or smell
Cough
Shortness of Breath
Fatigue
Congestion or runny nose
Nausea or vomiting
Diarrhea
None of the above
Required
In the last month have you been in contact with someone who was confirmed or suspected to have the Coronavirus/COVID-19?
*
Yes
No
Required
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