COVID-19 Testing  New Organization Enrollment Form
Please provide as much information as possible in order to help us provide you with an individualized testing program. Thank you!

Basic Information

Please use this field to provide the following information about this location:
1. WiFi. Network name and password.
2. Entry Requirements and Parking. Where to park, location to check in when they arrive etc.
3. Sample Collection Location. The room number (please make sure it has access to a table, chair, trash bin and power outlet for equipment setup).

Contacts