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Contact
CALL TODAY | 866.888.1099
Home
Products & Services
Standard Defense Package
Mobile Full Enterprise Field System
Thermal Screening
Daycare/Sr. Care, Extended Care
Film and TV Production Support Services
Restaurant an Food Service Industry COVID-19 Support Services
Agents
Pricing
Estimate Calculator
LNSGroup Credit Application
BHC Credit Application
Contact
Name
First
Last
Testing Time
Address
Date of Birth
Telephone Number
Gender
Ethnicity
Why are you getting tested for COVID-19?
Testing for Job
Presumed Exposure in United States - By Healthcare setting as a worker or visitor to COVID-19 infected individual
Presumed Exposure in United States - By Known community contact with COVID-19 infected individual
Presumed Exposure in United States - By UnKnown community contact with COVID-19 infected individual
Presumed Exposure outside United States - Manually Enter Overseas Travel with Country and (Month/Year)
Are you currently experiencing any of the following Symptoms?
Shortness of Breath or Difficulty Breathing
Fever greater than 100.4F (Using a thermometer)
Felt Feverish (without using a thermometer)
Sore Throat
Muscle or Body Aches
Cough
Headache
Other Symptoms
Not Applicable
Do you have any of the following pre-existing medical conditions?
hronic Lung Disease (asthma/emphysema/COPD)
Diabetes
Obesity
Cancer
Cancer Treatment
Heart Disease
Currently Pregnant
Could Possibly be Pregnant
Immunocompromised Condition
On immunosuppressive drug(s)
Other
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