Premium Health In-Home COVID Testing – Premium Health

Premium Health In-Home COVID Testing

Please complete this intake form to schedule your free in-home COVID-19 Testing. Once completed, we will contact you to set up your appointment based on your availability. ✓ Same Day Result!

Name *

Phone *

Email *

Appointment Date *

Availability *

9AM-3PM
12PM-6PM

Please select as many time windows as possible to ensure efficient scheduling

Address *

Address Line 1

Address Line 2

City

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Zip Code

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