California K-12 School Rapid Antigen Testing Program Onboarding Form

This is an onboarding form for all California schools outside of LA County who are considering participation in the school-based antigen testing program. Public school districts, charter schools, independent schools, and other afterschool programs and school-related camps are eligible to participate in this program.

Los Angeles County schools/organizations (public, private, and charter) should not use and/or complete this application form except in selected circumstances

Please email Edith Hernandez: ehernandez3@ph.lacounty.gov to find out more about how to enroll in Los Angeles County school testing programs. 

The California K-12 School Rapid Antigen Testing Program provides free testing supplies, training and software to schools to support COVID-19 testing. We provide free antigen tests, free reflex PCR tests and a free rapid molecular (PCR-like) test called CUE. We are also piloting home tests such as the Abbot BinaxNOW Antigen Self-Test. Our program provides the CDPH K-12 Schools CLIA certificate of waiver for all schools participating in the program. We also provide Abbott BinaxNOW antigen kits to schools who are using their own CLIA waiver.

This form should be completed by school testing administrators, or superintendents/administrators of the district/schools.

You will receive an automated email with more information upon completion of the form. Please read the email carefully. If you do not receive an automated email within 1-2 hours of completing this form, please email schoolbinax@cdph.ca.gov so that we can check your email address was entered correctly.

Please select the type of tests you are planning to use:
Which population segments do you plan to test? Please check all that apply.
CDPH has a statewide CLIA waiver to allow organizations who do not have a CLIA waiver to test.
Enter the point of contact for your organization. This should be someone who can receive regular contact about program updates and will be either managing the online testing platform Primary.Health (for schools using the state’s CLIA waiver, and schools using own CLIA and opting to use Primary.Health) or submitting monthly reports.
Enter a secondary point of contact for your organization (optional).
Enter your organization’s point of contact for signing the program Memorandum of Understanding (MOU). This should be your district superintendent or principal. In the confirmation email, you will receive a link to DocuSign to sign the MOU. This confirmation email will also be sent to the email you enter below.