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WELCOME 
Point Health Solutions
Order COVID-19 Screening Test
 
 
We just need you to answer a few questions and upload your insurance card to get your screening test sent to you 

Full Name:
Address
Phone Number:
Email:
Date of Birth (MM/DD/YYYY)
Gender
Male
Female
What company do you work for?
Do you have a cough?
Yes
No
Have you lost sensations of taste and smell?
Yes
No
Do you have a sore throat?
Yes
No
Do you have a fever?
Yes
No
Are you having difficulty breathing?
Yes
No
Have you travelled in the last 14 days?
Yes
No
Do you have direct contact with or are you taking care of a positive COVID 19 patient?
Yes
No
Please upload your insurance card:
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