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CIC COVID-19 Testing Program Sign-Up
Note that CIC intends to expand our COVID-19 Testing Program to other organizations in our regions. Anyone may use this form to express interest.
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Are you a CIC client?
Yes
No
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Cost aside, how many employees, total, would you ideally cover with your testing program?
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Your answer
Cost aside, what frequency would you ideally like to test your employees?
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As-Needed
3x per week
Daily
Other:
How many total tests do you guess you would employ per month during Phase 1, e.g. testing on demand, assuming the cost is $150/test before possible insurance reimbursement?
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Please enter the TOTAL number of tests per month covering all employees
Your answer
How many total tests do you guess you would employ per month during Phase 2, e.g. testing 2-3x per week, assuming the cost is $75/test before possible insurance reimbursement?
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Your answer
How many total tests do you guess you would employ per month during Phase 3, e.g. daily testing, assuming the cost is $10/test before possible insurance reimbursement?
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Your answer
Are you interested in learning about antibody testing options for your employees?
Yes
No
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What is your name?
*
Your answer
What company are you with?
Your answer
THANK YOU! Please feel free to contact us at
covid@cic.com
if you have questions, or please feel free to leave comments or suggestions here.
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