Residential Youth Facilities BinaxNOW Registration

 
 

Facility Information

 
 

Please note that we cannot mail to PO Boxes

 
 
 
 

Staff and Student Information

 
 
 

Testing Administrator

The testing administrator will be the person responsible for observing specimen collection, performing the Abbott BinaxNOW rapid-point-of-care antigen test, and logging results

 
 
 
 
 
 
 

Testing Reporter Information

The testing reporter will be responsible for all COVID-19 testing consent forms and reporting requirements.

 
 
 
 
 
 
 

Please complete the below attestation.