COVID-19 At-Home Test Kit Survey

Please select the option that is right for you.

Kits are available for $0 upfront cost to those who complete a short survey and meet clinical testing guidelines. For those who do not wish to take the survey or do not meet clinical testing guidelines, kits are available for $119.  

Please describe the option that best describes your symptoms:

If you have both severe and mild symptoms, select severe.

Have you been exposed to the coronavirus in the past 2 weeks?

Please select the option that most closely describes your level of exposure:

Do any of the following statements apply to you?

Please select the first option if ANY of these apply to you: