This order form is to be used by organizations that have received an invitation to partner with the State of California’s Testing Task Force (TTF) for COVID-19 antigen testing with At-Home (also known as Over the Counter, OTC, or Self-Test) tests.

To provide At-Home tests to Californians, the Testing Task Force has is working with several COVID-19 Testing Manufacturers. Your order will be filled based on existing inventory and you may receive a different brand of tests upon reorder. Instructions on how to run the tests will be provided with each test kit.

Please do not submit multiple orders. Your first order request will be sent to you as quickly as possible.

Please verify your order for accuracy before you submit. Once orders are approved, they cannot be changed or corrected.

 

 

Org Info

Organization Point of Contact

Delivery Point of Contact

This point of contact person should:
- Be available at their contact number (direct cell phone) to coordinate delivery of testing materials; and
- Be available to receive shipments during working hours.

Delivery Information

Please provide the address to which the order should be shipped.

Important:

~ Delivery address cannot be a P.O. Box
~ Delivery address must be in California
~ The Delivery Point of Contact must be available at this address to receive the shipment

Please review and verify the delivery address you entered is correct.
Any incorrect delivery information will result in delays to your delivery and delay testing at your site(s). 

Please consolidate your order requests as much as possible. This includes shipping tests to a central location, such as a district office.
If you must have kits shipped to more than one location, please submit a separate order form.

Please provide your best estimate for the number of tests required for a 4 week supply across all testing locations for your organization.

Based on supply availability, you may recieve different test quantities than what your organization requests. Our team will work to get as close to the quantity you ordered. 

Please confirm your understanding of the following: