Testing Registration Form (COVID-19 and Other)

Test Registration (COVID-19 Rapid and Other Tests)

Thank you for your interest. Payment is due at time of service. For COVID-19 testing, please come to the drive-through window to fill out paperwork and provide payment. Pharmacy staff will then direct you to park, and we will test you in your vehicle. We provide written results as part of our rapid testing service. The Rapid PCR test and documentation we offer is suitable for most travel requirements, but it is the patients responsibility to verify that what we offer will meet your needs.
Which test are you scheduling today?*

Rapid Antigen Test ($40)RT-PCR test (i.e. Rapid PCR)Prothrombin Time (PT)/INR Test
Rapid Antigen Test Quantity
Rapid PCR Test Quantity
PT/INR Test Quantity
Show Testing Additional Information?

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Additional information about COVID-19 tests:

https://www.mayoclinic.org/tests-procedures/covid-19-diagnostic-test/about/pac-20488900

RT-PCR test - Also called a molecular test, this COVID-19 test detects genetic material of the virus using a lab technique called reverse transcription polymerase chain reaction (RT-PCR). A fluid sample is collected by inserting a long nasal swab (nasopharyngeal swab) into your nostril and taking fluid from the back of your nose.

RT-PCR tests are very accurate when properly performed by our health care professionals.

Antigen test - This COVID-19 test detects certain proteins in the virus using a long nasal swab to get a fluid sample.

A positive antigen test result is considered accurate when instructions are carefully followed, but there's an increased chance of false-negative results — meaning it's possible to be infected with the virus but have a negative result. Depending on the situation, a doctor may recommend a RT-PCR test to confirm a negative antigen test result

Willey Pharmacy - At Willey Pharmacy, we analyze rapid RT-PCR and Antigen tests onsite and provide written test results within the same visit. PCR test results are typically available in 30 minutes and Antigen test results are typically available within 15 minutes.
Testing Appointment. *
Name of person being tested*

First NameLast Name
Phone Number *
Please enter a valid phone number where you can be reached if there are questions
Alternate Phone Number
Please enter a valid phone number.
Email*
example@example.com
Gender*

FemaleMale
What is the age of the person being tested?*
Note: Minors will need to have a parent or guardian present
Please check if person being tested has symptoms below

Fever or chillsCoughShortness of breath or difficulty breathingFatigueMuscle or body achesNew loss of taste or smellSore throatCongestion or runny noseNausea or vomitingDiarrheaOther
Is this test required for travel?*

YesNo
Additional Notes / Remarks. If you wish to schedule with a spouse or additional person, please enter their name(s) here. They will need to create their own appointment but can arrive in the same time slot.
I hereby declare that all the given information are accurate.*

Yes
Thank you for choosing Willey Pharmacy! We are conveniently located at 3625 Wrangle Hill Road, Bear, Delaware 19701, behind the new WaWa at Red Lion Hundred, at the corner of Route 72 and Route 71, just off Route 1.
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Test Registration (COVID-19 Rapid and Other Tests)

Thank you for choosing Willey Pharmacy! We are conveniently located at 3625 Wrangle Hill Road, Bear, Delaware 19701, behind the new WaWa at Red Lion Hundred, at the corner of Route 72 and Route 71, just off Route 1.