Patient Registration

Information that we will need:

Date and Time
Pick a time slot that works for you
What is your cell phone number?
What is your address?
Select state
    No Identification source
    Driver's License
Please note: Only the following file types will be accepted: .jpg, .png, .bmp, .gif.
On March 15th, 2022, the US Health Resources & Services Administration (HRSA) announced that it would no longer be funding COVID-19 testing or treatments. As a result, all of’s COVID-19 services will now be billed through your insurance provider. Patients who are uninsured will be charged a reduced fee of $49.00 for the test sample collection with a care provider, payable by debit or credit as part of the booking process.
  • Please note: Only the following file types will be accepted: .jpg, .png, .bmp, .gif.
  • $49.00

By placing my signature below, I certify that the information on this patient registration is correct and I fully understand and agree with the following:

Cost of visit

Some same-day appointments may include a delivery fee in order due to high demand in the area.

Covid-19 test
Total cost $0.00
Payment is available after verification

Antibody Test. How it works: 1. Schedule Appointment: Book your Covid Antibody test appointment here. You will need to provide your personal and insurance information to complete your booking. 2. Check-In: Log in to the app and check-in 15 minutes before your appointment. You will be asked to confirm your information and appointment details with our virtual front desk. 3. Start appointment: Meet with one of our providers through video via the telemedicine link. A live medical assistant will show you how to self-collect your sample for testing. 4. Get Results: Following the appointment, log in to the app to review lab orders submitted by the provider. For more inquiries, please contact: +1 (888) 215-6182.