Campus Departure Covid-19 Testing Request

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You must complete this form if your cadet requires a Covid-19 test prior to flying.

Email *

I understand that the CARES Act fund that reimburses doctors and other medical providers for caring for uninsured individuals was scaled back in March of 2022 and ended completely in early April 2022. Specifically, on March 22 the Uninsured Program stopped accepting new claims for testing and treatment due to lack of sufficient funds. Furthermore, I understand that federal law does not require health plans to cover tests if the reason for testing is not an individualized diagnosis or treatment. *

I understand.

Should the CARES Act or my insurer fail to pay for testing, I agree to pay for the test, which may cost me $299.00 or more. *

I agree.

Cadet name *

Flight Departure Date *

YYYY

Time

Time frame requirement *

Within 24 hours of flight departure

Within 48 hours of flight departure

Within 72 hours of flight departure

Other:

A copy of your responses will be emailed to the address you provided.

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