COVID Test Registration at NFP

We perform our COVID-19 testing at our

West 117th Community Health Center.

11709 Lorain Avenue, Cleveland, OH 44111

All testing is done in the parking lot of the health center using a nasopharyngeal swab (PCR test). All testing is done by appointment only – for patients of all ages – regardless of ability to pay.

Testing is performed at no cost to you. There is no charge with insurance and programs are available to cover the cost if uninsured.

You will be notified of your test results within 2-3 days, and provided with a treatment plan if needed.

The COVID-19 test is a point in time test and does not ensure or prevent future infections.

Anyone scheduled to be tested should remain vigilant and follow social distancing and masking guidelines leading up to and after the test is done.

Please complete the information below to pre-register for your test.

I want a COVID-19 test because my family or I: *

Have symptoms and feel ill (i.e cough, fever, fatigue, sore throat, headache, loss of taste or smell) Am worried or know that I have been exposed to someone with COVID-19 coronavirus, but I do not currently have symptoms or feel ill Need a test for travel domestically or internationally

Current evidence shows that when a person is first exposed to COVID-19, they do not test positive immediately.

It is best to be tested 4-6 days after the possible exposure (for example, exposed on Saturday, testing likely to be most accurate the following Wednesday).

If you are unsure about the degree of exposure or when to request a COVID-19 test, please call 216.281.0872 to discuss with an NFP provider.

Please complete the information below to pre-register for your test.

Registering for a COVID-19 test appointment does not include a full medical exam. If you are worried or concerned about your symptoms, we encourage you to call 216.281.0872 to make an appointment with a provider to discuss your symptoms or treatment options.

The test we are currently using has a turnaround time of 2-3 days. Test results can be shared with you by text, email or MyChart. In most cases, travel destinations with COVID-19 restrictions require that testing be done within a specific window of time prior to travel (not when the test results are available). It is your responsibility to schedule testing within the timeframe needed specific to your travel plans. If you have questions about the timing of your test, please call 216.281.0872.

Please complete the information below to pre-register for your test.

Full Name: *

First Name Last Name

Date of Birth *

Month Day Year

Sex *

Mobile Phone: *

Address *

Street Address

Street Address Line 2

City

Postal / Zip Code

Email

example@example.com

Additional Family Members to be tested (List Name AND Date of Birth)

Additional Family Members to be Tested

Insurance *

I have health insurance I do not have health insurance

Front of Insurance Card *

Back of Insurance Card *

Front of Family Member's Insurance Card(s), Please include if different insurance than first patient listed *

If your family members registering for a test have insurance and you do not, please upload their insurance card and not a photo ID.

Photo ID (Drivers License or State ID) *

Photo ID (Drivers License or State ID) of any other Family Members--OR load their insurance card(s)

Back of Family Member's Insurance Card(s) *

If you don't see your preferred time on the form for testing, please contact our office at 216.281.0872 to discuss additional options for time slots and days.

Covid Testing Schedule *

COVID Travel Testing Schedule *

COVID TELEMEDICINE VISIT SCHEDULE

COVID-19 Testing at NFP