Atlanta Area Mobile COVID-19 Testing

Our testing includes COVID-19 Coronavirus Antibody and Antigen Tests.

An antibody test can possibly help to reveal if a person has already been exposed to an infection, by detecting existing antibodies in their blood or serum.

An antigen test reveals if a person is currently infected with a pathogen such as the COVID-19 Coronavirus.

Covid Test Request Form

First & Last Name:*

Date:*

D.O.B:*

Address:

City:

Zip:

Country:

State:

Insurance Information

Primary Insurance:

ID Number:

Group Number:

Back of Insurance Card

Billing Address:*

Upload Scan / Photo of Insurance Card - Front:

Max upload file size 2MB. Allowed File Type - jpg, .jpeg, .pdf, .doc, .docx.

Today’s Date:

Upload Scan / Photo of Insurance Card - Back:

Max upload file size 2MB. Allowed File Type - jpg, .jpeg, .pdf, .doc, .docx.

Your Signature:*

Vital Signs - For Staff Use Only

Temperature:

Pulse:

02 Saturation:

Results:

Negative Positive

Print COVID-19 Test Request Form

Print COVID-19 Authorization For Minors

image of a person administering a covid-19 test to a man

Covid-19 Testing

Covid Test Request Form

Insurance Information

Back of Insurance Card

Vital Signs - For Staff Use Only

Minority-Owned Business

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