Jump to Content

Available Forms

COVID Test- Non Patient

Rapid Covid for non-established person

I understand that I have requested , a nasal rapid COVID test only at Ideal Pediatrics and that, by doing so, I am not establishing care with the practice or any of its providers. Any result obtained will be informational only and any advice based on that result should come from my primary care provider or the local health department.

The fee for this test is $75, to be paid at the time of making the appointment. This fee is only refundable if the test is cancelled with greater than 24 hours notice.

I also understand that I must arrive on time and that arriving more than 5 minutes late will likely result in the test not being performed and fees not being refunded.

I have been informed that when I arrive at the office, I must TEXT the office to let them know I have arrived for my test.

If I would like a confirmatory PCR Nasopharyngeal swab, there will be an additional $25 collection fee, charged to my card on file at the time of service, and the test itself will be billed by a third party lab to my insurance.

Type your first and last name for acknowledgment
* Required field