STREP ANTIGEN TESTING

Strep Rapid Antigen Test Registration

***ALL TESTING is currently happening in the BACK PARKING LOT behind Skippack Pharmacy.***

Your reservation is not held until you complete your registration successfully and receive a GREEN CHECK MARK at the end. In order to guarantee your spot, do not navigate away from this page until you've submitted the form.

BEFORE YOU PROCEED

1. Special instructions for minors: 0-15: Parent or legal guardian needs to fill out form and accompany patient to visit. Ages 16-17: Parent or legal guardian needs to fill out form only. A parent can help perform the throat swab if it is for a child.

2. Any positive results would need to be followed up with further tests by your doctors. A negative test result is not a 100% guarantee that you do not have Strep throat and does not guarantee that you will not get it in the future either.

3. The cost of a Strep Rapid ANTIGEN test is $45 (discounted from $100). We CANNOT bill your medical insurance or Medicare for the testing as we can only bill prescription plans at the pharmacy for medications and testing is not covered by your prescription plan. Many of our patients have had success in providing their receipt to the insurance company for reimbursement after the test. We will provide you with a results sheet/invoice which has our Tax ID, NPI, Lab License No, and other pertinent details insurance companies require; however, the pharmacy is not responsible in the event your insurance does not reimburse you - please confirm with your insurance company that they will reimburse you as the pharmacy will not receive any payment.***The test is non-refundable - if you are using this for travel and travel plans change or the destination does not require it any further, you will receive a credit; however, no refunds will be given***

4. Cancelling or rescheduling your appointment: if you make a payment via credit card and cannot make your appointment or no longer need the appointment, you may TRANSFER the appointment to a friend, family, etc., you may keep that appointment on file with our pharmacy as a CREDIT which can be used for a future test, or use the money for credit in-store. To cancel your appointment, you can email clinic@skippackpharmacy.com. No refunds are available but a credit will remain on file for you. If you were going to pay cash in person and need to cancel/reschedule, please email clinic@skippackpharmacy.com.

5. Results are EMAILED to you after the test within 1 hour.

6. No guarantees can be made that the documentation provided by Skippack Pharmacy is valid for travel or other purposes. Rules change daily and why we cannot make any promises of what test is used for which purpose. We recommend checking with the airline / country to see what specific test they may require.

7. If you want to schedule Strep tests for a family or a number of people coming in the same car, please select consecutive appointments & you can come together at the first designated appointment you have selected. If coming to test a number of family members, we recommend you come together in the same car when possible to allow us to expedite your tests.

8. The parent of the child can assist with the throat swab process.
I understand that I am scheduling to receive testing for Strep for myself or a minor on whose behalf I am authorized to provide consent. I consent to testing for Strep and agree to these terms. Click next after selecting the box.

Consent & acknowledgments
Please read the consent below. I voluntarily consent and authorize Skippack Pharmacy to conduct the collection, testing, and analysis for the purposes of a Strep diagnostic test for myself and/or my child(ren) and/or my legal dependent(s) as applicable. I understand that the type of test I am signing up for is the Strep rapid antigen test. The test will consist of a self-collected throat swab. To the fullest extent permitted by law, I hereby release, discharge, and hold harmless, Skippack Pharmacy, without limitation, any of their respective partners, officers, directors, employees, representatives, and agents from any and all claims, liability, and damages, of whatever kind or nature, arising out of or in connection with any act or omission relating to my Strep diagnostic test or the disclosure of my Strep test results to my Employers and other Government Agencies. I understand and agree that my Strep test results may be sent to me by text message, telephone, or email by Skippack Pharmacy or any third-party organization, and I authorize the disclosure of my Strep test results to such organization. Should you require treatment from a health care provider that participates in one of these exchanges who does not have your medical records or health information, that health care provider can use the system to gather your health information in order to treat you. For example, he or she may be able to get a laboratory or other tests that have already been performed or find out about treatment(s) that you have already received. I have read the contents of this form in its entirely and voluntarily consent to undergo diagnostic for Strep testing and release of the result to my employer and other government health agencies. Any positive results would need to be followed up with further tests by your doctors. A negative test result is not a 100% guarantee that you do not have a Strep infection and does not guarantee that you will not get it in the future either. Repeated test may be needed as clinically indicated. The information provided above is true to the best of my knowledge.
By checking this and signing below, I agree that I do not hold the pharmacy responsible if the insurance rejects or denies payment for the test. The pharmacy will provide a results sheet with information to submit to the insurance company, if need be; however, the pharmacy is not responsible for submitting any or assisting me with submitting any information to my insurance company. On the lab results/invoice sheet I will be emailed, the information included on the report includes the following: Laboratory Name, Laboratory Address, Laboratory Phone Number, Laboratory Website, Lab CLIA number, Lab ID, Tax ID, NPI Number, Patient Name, Date of Birth, Address, Test Specimen Method, Specimen Collection Date, Test Date, Procedure Date, Diagnosis Code, Test Performed, Measured Result.
By checking this and signing below, I understand and agree that the test is NON-REFUNDABLE. I will not call/email to ask for a refund in the event I cancel, plans change, travel destinations do not require the test, or I do not need the appointment anymore. Due to higher demand and limited appointment availability by checking here, I am aware that the Strep rapid antigen test is NON-REFUNDABLE (no exceptions). If I cannot make my scheduled appointment time, I may use the same appointment at a different time, transfer the appointment to a family member or friend, or use it as store credit.
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DURING YOUR APPOINTMENT:
- Drive to Skippack Pharmacy (upon arriving to the complex, drive around to the BACK PARKING LOT of the pharmacy & pull into a parking spot) Only AFTER you arrive, please call our direct testing line at 610-584-7937 (please do not hang up until one of our testing members picks up the phone to check you in).
- Please inform our team member the following: 1) First & Last Name and Age, 2) You are here for your STREP RAPID ANTIGEN TEST, 3) If you paid in advance via credit card or paying cash in person.
- A specialist will come out to your car & hand you a throat swab. How to perform the test: Stick your tongue out, find the tonsils at the back of the throat and swab tonsils on both sides for a few seconds each (about 4 times). Avoid touching the tongue, cheeks, or teeth with the swab. Insert the throat swab back into the sleeve it came out of. Once completed, please pass the throat swab back to our team
- Once you pass the Throat Swab back to our team in its sleeve, you are ready to go. Our team will EMAIL you the results as soon as they are processed.
  Please do not arrive earlier than 5 minutes prior to your appointment time. If you need to come earlier or later, you do not need to call or email to inform us, you can come up until 6:15PM on weekdays or 2:15PM on Saturday at the testing site BEHIND Skippack Pharmacy.
- If for any reason, you do not receive a EMAIL within 1 hour (also keep an eye out in your spam folder), please call 610-584-7937 and inform our team of your name, test taken, and time of your appointment. They will work to resend you the results in the event of any technical glitch.
Payment

The cost of the test and lab fees is $45 per test (our pharmacy cannot bill medical insurance; therefore, patients are responsible for the testing fee up front). If you use a credit card, a convenience fee of $5.00 will be added per test. This is NOT a hold on your credit card, by inputting your credit card number below, you will be charged for the test immediately. By inputting your credit card information below, you understand that the test is non-refundable.
How are you paying for the test?

CREDIT CARD - I will provide my credit card information below and be charged $50. On a rare instance, you may enter your card info & the appointment will be confirmed but our payment processor Square will not charge your card. If this happens, we'll ask you for your card information again at check-in & we assure you that will not be double charged. Click the checkbox next to "Rapid Strep Antigen Test (Performed by our CLIA-Medical Lab)" below AND input your credit card information.CASH - I will pay cash in person and bring $45 for each Strep test I sign up for (i.e. if signing 3 separate forms for 3 family members, please have $135). To help prevent the spread of illness, no change will be given. Please have the exact amount in a zip lock bag or envelope with your first name, last name, date of test, and amount in the bag. You DO NOT have to click any of the options below and DO NOT enter your credit card information.

Select the item(s) below ONLY if you are paying via credit card. If you are paying via cash, DO NOT CHECK THE BOX BELOW.

Rapid Strep Antigen Test (Performed by our CLIA-Medical Lab)$45 per test + $5 convenience fee if using credit card. If signing up multiple family members, you will need to submit a separate form for each person.

$50.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Please click on the box on the left and then hit submit below. If you do not see a green checkmark on the next page or get an error, your submission did not go through and your appointment is not confirmed. Unfortunately, you will have to fill out another registration form. Please keep an eye out in your regular or spam email for an email from clinic@skippackpharmacy.com (if you do not receive one, inform our team when you check-in). By checking this box, you also acknowledge this test is non-refundable and that IF you entered your credit card information and hit submit BUT the credit card does not get processed, you will provide the card information again at check-in (you will not be double charged).
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