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COVID-19 Drive Screening Form Please Printers and Last Name: DOB: Sex: Telephone number: Email (for results to be sent to you): Race: Ethnicity: Preferred Language: Mailing Address: Street Address:

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How to fill out covid drive-up screening form

01

Step 1: Locate a designated covid drive-up screening site in your area.

02

Step 2: Visit the drive-up screening site and park in the designated area.

03

Step 3: Stay in your vehicle and follow any instructions provided by the healthcare staff.

04

Step 4: Fill out the covid drive-up screening form provided by the staff.

05

Step 5: Provide accurate information in the form, including personal details, symptoms, and recent travel history.

06

Step 6: Follow any additional instructions or guidelines provided by the staff while filling out the form.

07

Step 7: Submit the completed form to the healthcare staff.

08

Step 8: Wait for further instructions or guidance from the staff regarding the next steps.

Who needs covid drive-up screening form?

01

Individuals who are experiencing symptoms of COVID-19

02

Individuals who have been exposed to someone with COVID-19

03

Individuals who have traveled to high-risk areas

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What is covid drive-up screening form?

The COVID drive-up screening form is a document used to collect information from individuals seeking to be screened for COVID-19 at designated drive-up testing locations.

Who is required to file covid drive-up screening form?

Individuals who wish to be screened for COVID-19 at a drive-up testing site are required to fill out the COVID drive-up screening form.

How to fill out covid drive-up screening form?

To fill out the COVID drive-up screening form, individuals need to provide personal information such as their name, contact details, symptoms they are experiencing, and any relevant travel history.

What is the purpose of covid drive-up screening form?

The purpose of the COVID drive-up screening form is to gather essential information to determine whether individuals should be tested for COVID-19 and to streamline the testing process.

What information must be reported on covid drive-up screening form?

The information required includes the individual's name, contact information, symptoms, exposure history, and any pre-existing health conditions.

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