ANDOR LABS DRIVE-UP
Patient Information
First test?
Employed in healthcare?
ICU?
Hospitalized?
Symptomatic as defined by CDC?
if yes, then Date of Symptom Onset
Pregnant?
Travel Based Required Test?
Lab To Lab Referral?
Resident in a congregate care setting (including nursing homes, residential care for people with intellectual and developmental disabilities, psychiatric treatment facilities, group homes, board and care homes, homeless shelter, foster care or other setting):
Insurance Information
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