COVID Testing Evaluation Form

If you feel that you have had exposure to COVID, or have COVID symptoms please fill out the form below and we will
be in touch promptly to schedule you a telemedicine evaluation followed by urgent COVID testing.
Our results couldn't be more accurate,
and come back within 24-48 hours.

COVID-19 Telemedicine Appointment Request Form



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.


After hitting the submit button above please scroll up to see the message: 
Thanks for filling out the form! My staff will be in touch shortly to connect you with us. 
If it's there, perfect! We'll be in touch shortly. 

However, if your form fails to submit, simply give us a call at (908) 450 7002 and we'll be happy to take care of you.

PremierMD
Premier Medical Acupuncture

757 Route 202-206, Suite 104
Bridgewater, NJ 08807

Email: premiermd@gmail.com      
Phone: (908) 450 7002                  
Fax: (908) 941 2715
Billing:
danak@mcbcollects.com

Feedback

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Any feedback would be appreciated.