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Early Childhood Education COVID-19 Antigen Test Request Form

Please provide the following information to get started.

optional information:

  • Please be able to accept deliveries Monday-Friday 8 am to 5 pm.

  • We will try to accommodate all requests, but we cannot guarantee delivery during your specified dates and times.

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Please let us know if you have any comments or concerns on your order request. If there are unusual delivery instructions or active outbreaks, include this here.

Please request the maximum number of tests you can store and use for  a 1-month period.

Enter the number of COVID-19 antigen tests (not boxes) you would like to request.

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