COVID-19 Test Online Registration Form for Alhambra Unified School District

You are receiving this questionnaire as part of a COVID-19 testing program arranged by Alhambra Unified School District. Our company, OneHealth Telemedicine, LLC, employs physicians, who will review this information to confirm in order to approve your COVID-19 test. The answers to these questions are confidential and protected by HIPAA. No confidential information will be shared with your school district without your written consent. All information is stored securely. BEFORE YOU START, IF YOU ARE EXPERIENCING ANY OF THESE SYMPTOMS, STOP AND CALL 911: Constant chest pain or pressure- Extreme difficulty breathing- Severe, constant dizziness or light-headedness - Slurred speech- Difficulty waking up.