Maryland Summer Camp COVID-19 Test Request Form

The Maryland Department of Health’s (MDH) COVID-19 Testing Task Force has Abbott BinaxNOW (PRO) tests and over-the-counter (OTC) at-home tests in stock. MDH will provide these tests free to Maryland camps for campers and staff to be used at their own discretion.

To be eligible to receive Abbott BinaxNOW PRO tests, camps must hold a CLIA waiver. Camps must have an individual on-site to collect COVID-19 specimens for testing and process the test samples. Per the latest executive order, this individual must be licensed, registered, or certified by MDH or a Maryland health occupations board, have appropriate training and supervision. In addition, any person with a high school degree or GED diploma can administer the Abbott BinaxNOW PRO tests after receiving the appropriate training.

Camps may also request over-the-counter (OTC) at-home rapid antigen tests, made by iHealth. These tests do not require a CLIA waiver as they are intended to be administered off camp grounds. More information regarding OTC test usage can be found here.

At this time, camps may continue to conduct the confirmatory PCR at their own discretion, based on their current environment and overall assessment of risk. Please refer to CDC guidance on antigen testing and COVID-19 Community Levels for more information.

If interested, please fill out the attached request form and include an estimate of the number of tests needed for your camp population. MDH will review all requests and determine allocations based on test availability. All requests received each Thursday at 5pm will be added to the following week's distribution list.

MDH is unable to receive tests back in our facility once delivered, therefore, we encourage you to request the number of tests you will realistically need. If you find the need for additional test supplies, please provide at least three weeks notice to ensure supplies will be delivered when needed. If you have any questions or concerns, please contact mdh.k12testing@maryland.gov.

First Name

Last Name

Title

Email Address

Phone Number

Camp Name

Camp Address (Line 1):

Camp Address (Line 2):

Camp Address (City):

Camp Address (State):

Camp Address (ZIP Code):

Please enter the total number of campers on site at your camp:

Please enter the number of staff members on site at your camp:

Would you like to order Abbott BinaxNOW point-of care (POC) test supplies?

These tests require a CLIA waiver and trained onsite staff to administer tests.

Yes

Would you like to order over the counter (OTC) at-home test supplies?

Yes

Shipping Information

Please enter the shipping address where you would receive the rapid test supplies.

Please indicate the date your tests are needed by

Note: Please allow 2-3 weeks for delivery.

mm/dd/yyyy

Is your shipping address the same as the address for your camp you provided above?

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