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Appointments Request Form
+ EXISTING PATIENTS
+ MEDICAL APPOINTMENT

New COVID-19 Test Appointment Request:

Date of Birth:

 

COVID-19 Rapid PCR/NAAT $150 or Rapid Antigen $75 for any INTERNATIONAL TRAVEL, EMPLOYMENT, or PRIVATE EVENT

 

 

MOBILE DRIVE OUT FEES range $150-$250 depending on location and timing of the day. We are available 24/7 for testing.

Add Billing Method / Credit Card on File:

Your credit card WILL NOT BE CHARGED without prior discussion and approval.

*If international credit card enter "111" for zip code

 

 

If having any trouble booking on-line please call or text 888-663-6631 (888) MODO-MD-1 for assistance.

Issues with the form? Click here!