• Rapid COVID-19 Testing

    Appointment and Consent Form
  • The cost of the test is $99.00

    Family Care Pharmacy does not accept insurance for the test.
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  • By signing this form, I agree to the following:

    a. I authorize this COVID-19 testing unit to conduct collection and testing for COVID-19 through a nasopharyngeal swab (a swab in the nose) or an oral swab (a swab in the throat).

    b. I authorize my test results to be disclosed to the Florida Covid19 Reporting Portal.

    c. I acknowledge that a positive test result is an indication that I should self-isolate and wear a mask or face covering as directed.

    d. I understand the Family Care Pharmacy is not acting as my c medical provider, this testing does not replace treatment by my medical provider, and I assume complete and full responsibility to take appropriate action when I receive my test results. I agree I will seek medical advice, care and treatment from my medical provider if I have questions or concerns, or if my condition worsens.

    e. I understand that, as with any medical test, there is the potential for a false positive or false negative COVID-19 test result.

    f. I understand that there will be a $99.00 charge for this test payable over the phone at 813-659-9777. Calling hours are 9am to 6pm Monday to Friday only. 

    I, the undersigned, have been informed about the test purpose, procedures, possible benefits and risks, and I have received a copy of this Informed Consent and the Notice of Privacy Practices. 

  • When you arrive for your appointment please park on the West side of our building by our electronic billboard street sign. There are 2 curbside spaces where we will perform your test carside. 

     

    Please call us prior to your test at 813-659-9777 to pay via credit card over the phone to secure this appointment. 

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