At-Home PCR Covid Testing Appointment Form

Convenient At-Home Covid Testing

Submit form below and a representative will be in touch with you shortly.
Full Name
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address
example@example.com
Please indicate whether you have a US Social Security Number (If you do not, please note there is an additional $100 surcharge per person indicated at checkout)
Please select the preferred 2 hour start time slot for your PCR Covid-19 test below...
Preferred Appointment Day & Time...
Any Special Instructions or Preferences?
COVID-19 Testing
prevnext( X )
COVID-19 PCR Test$225.00
$225 for first person & $50 for each additional person

Quantity

Non-US Citizen surcharge$100.00
$100 per person if a Non-US Citizen

Quantity

Total $0.00
***Cancellation may be made with full refunds anytime before the 12-hour window of a scheduled appointment. To reschedule or cancel your appointment, send your email to manager@gehealthit.com. Please note, there will be a $75 processing fee for any cancellation notice or request to reschedule submitted 12 hours or less of your scheduled appointment.
***CARES Act Reimbursable
The cost of laboratory testing will be billed to your insurance provider. Under the CARES Act, COVID-19 lab fees are often covered by insurance, but GE Health Solutions Inc. cannot guarantee coverage. If your insurance provider does not cover the lab fee, the lab company (Bioreference) will bill you directly. It is always a good idea to check with your insurance provider if you have questions about whether the lab fee will be covered.
Please verify that you are human
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Convenient At-Home Covid Testing

COVID-19 Testing