COVID Testing Evaluation Form

COVID-19 Telemedicine Appointment Request Form

This form is geared for NJ school employees, teachers, administrators, staff, and their families.

We will promptly connect with you for a telemedicine appointment, evaluate you, and either direct you to our office for a COVID-19 nasal swab or email you a prescription to take to a nearby testing site.

Even if we don't take your health insurance, or if you are uninsured, we will take care of you charge-free for COVID-19 evaluation and testing.