Monroe County, NY COVID-19 Testing Registration Form

PRE-REGISTRATION ENCOURAGED! WALK-INS WELCOME.

Patients under the age of 12 months are ineligible to receive a rapid antigen test at our facility. Patients under the age of 18 must be accompanied by a parent or guardian with proper consent documentation.

* Required Fields

Confirmation of appointment will be sent to this email.
Available date/time Unavailable Selected

Person

This email address will receive notification of test result.
If this person needs special accommodations please indicate above.
School/Employer Info
YOU WILL NOT BE ABLE TO EDIT THIS INFORMATION AFTER CLICKING THE SUBMIT BUTTON BELOW. PLEASE MAKE SURE ALL INFORMATION IS CORRECT.