DoctorNow At Home Antigen Test Registration

DoctorNow is pleased to offer No Cost Antigen Tests delivered directly to your home.
 
Starting January 15, 2022 the Federal Government requires health plans to cover up to 8 at home Covid-19 Antigen Tests per person per month. 
 
DoctorNow accepts all participating plans in addition to offering options for those that do not have insurance.
 
Under no circumstance will DoctorNow bill you directly for these tests.

INSTRUCTIONS- PLEASE READ BEFORE YOU START:

- Please review our full terms and conditions at the end of this registration form.
- Have your ID & insurance card ready to upload during the registration process.
- Please note you can request 8 tests per family member, which you can list during registration.
- Make sure to complete the entire registration process, including the last section titled "Acknowledgements," which require you to sign electronically.
- You will see a Thank You message, once you have completed the registration process. 

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* 1. First Name:

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* 2. Last name:

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* 3. Gender?

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* 4. Date of birth:
**Please make sure to use the following format (MM/DD/YYYY)**

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* 5. Email address:

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* 6. Shipping Address:

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* 7. Cell Phone Number - Important To Receive Updates

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* 8. Upload a photo of your driver's license or government issued ID (front side)

If the person being tested is a minor, please upload the Drivers License of Parent or Guardian.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 9. Do you currently have health insurance?

 
 20% of survey complete.

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