Note: This order form is intended for organizations outside of Los Angeles County.
Los Angeles County organizations can access at-home testing resources through LA County Department of Public Health. Please do not use this form; for more information, please visit LA County At-Home Testing Resources.
Must be the person's direct phone number (cell phone is best, no extensions)
Important: Please review and verify your address to avoid delays.
Please consolidate orders when possible. Ship to a central location, like a headquarters or district office. If tests must be shipped to more than one location, submit a separate order for each address.
Once approved, orders cannot be changed or corrected