DO NOT REGISTER YOUR KIT UNTIL YOU ARE READY TO COLLECT THE SALIVA SPECIMEN.
To begin your kit registration please start by completing the form below and follow the simple instructions.
Have you eaten, drink anything, chewed gum or smoke in the last thirty (30) minutes?
Please be aware that all persons are asked to avoid drinking water for at least 20 minutes and not to eat or drink anything else, smoke, brush your teeth or chew gum for about 30 minutes before collecting your saliva specimen. That way, the samples are as clean and contaminant-free as possible.
That is perfect. Please click the Next button below to continue.
Name of the person taking this test.
Note: Please be sure to match the collection kit serial # with the person you enter in the next steps. (if there are multiple persons in your household being tested)
Is this person a minor (child)?
We need this information to be able to securely deliver test results under the guardian's profile / email address.
Your Name (Parent / Legal Guardian)
Statement of Authorization
I certify that I am the parent / legal guardian and “personal representative” of the minor child and am authorized to exercise the minor’s HIPAA Privacy Rule rights with respect to protected health information (PHI).
Email Address of person taking this test
This is to be sure we provide results to the correct person. THIS IS WHERE TEST RESULTS WILL BE SENT TO.
Date of Birth of person taking this test
Date Format: MM slash DD slash YYYY
In the past two weeks what has been your exposure to COVID-19?
I’ve had close contact with someone who has been diagnosed with or presumed to have COVID-19
I’ve had close contact with someone who is sick but has not been diagnosed with COVID-19
I live or work in a congregate setting where people reside, meet, or gather in close proximity such as a healthcare setting, office building, homeless shelter, assisted living facility, group home, prison, detention center, school, or workplace
I’ve had no known exposure
Are you currently experiencing any of these symptoms? (Select all that apply)
Fever or chills
Shortness of breath or difficulty breathing
Muscle or body aches
Loss of sense of taste/smell
Nausea or vomiting
Generally not feeling well
Blue-colored lips or face
None of these apply to me
Do any of the following conditions apply to you?
I am 65 years of age or older
I am pregnant
I am very overweight or obese (BMI ≥40)
I have a chronic condition (e.g. diabetes, high blood pressure, kidney disease or on dialysis, liver disease, lung disease, etc.)
I have heart disease (e.g. previous heart attacks, heart failure, etc.)
I regularly use tobacco or nicotine products (e.g. cigarettes, e-cigarettes, vapes, hookah, etc.)
I have a condition that affects my ability to cough (e.g. had a stroke)
I have a condition that weakens my immune system or makes it harder to fight infections (e.g. AIDS, cancer, lupus, rheumatoid arthritis, solid organ or bone marrow transplant, etc.)
I am taking medication that weakens my immune system (e.g. steroids, chemotherapy, immunologics, etc.)
None of the above apply to me.
BE SURE THIS SERIAL NUMBER IS MATCHED TO THE PERSON JUST ENTERED ON THE LAST PAGE
Enter the Barcode ID / Serial Number (located on the tube as pictured above)
(Begins with two capital letters)
Re-Enter the Barcode ID / Serial Number
(Begins with two capital letters)
Is this test for travel to Hawaii?
Is this test for travel to Turks and Caicos?
Is this test for travel to Jamaica?
IF YOU ARE TRAVELING TO HAWAII, COLLECTION OF YOUR SPECIMEN MUST BE SUPERVISED OVER VIDEO. FURTHER INSTRUCTIONS WILL BE PROVIDED TO COMPLETE THIS PROCESS.
IF YOU ARE TRAVELING TO TURKS AND CAICOS ISLANDS, COLLECTION OF YOUR SPECIMEN MUST BE SUPERVISED OVER VIDEO. FURTHER INSTRUCTIONS WILL BE PROVIDED TO COMPLETE THIS PROCESS.
IF YOU ARE TRAVELING TO JAMAICA, COLLECTION OF YOUR SPECIMEN MUST BE SUPERVISED OVER VIDEO. FURTHER INSTRUCTIONS WILL BE PROVIDED TO COMPLETE THIS PROCESS.
Authorization for Use or Disclosure of Protected Health Information (Required by the Health Insurance Portability and Accountability Act, 45 C.F.R. Parts 160 and 164)
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You are almost finished registering your kit! Click the Submit button below to submit your registration and then follow the instructions on the next page for the collection of your saliva specimen.
One last question...
How did you hear about GetTestedNow.com?
We truly appreciate your feedback!
G3 Global Services
Referral from Family / Friend
Thank you for providing that information!
Date Format: YYYY dash MM dash DD
This field is for validation purposes and should be left unchanged.