At-Home Rapid COVID-19 Tests for Innisfil Transit

***This form must be submitted in order to be eligible to receive a kit of 25 rapid antigen tests.*** Upon completion of this form the Town of Innisfil will use the email address provided to contact you directly with more information about how to pick up your rapid COVID-19 antigen test kit. Please be aware that drivers must be able to pick up their kits from Innisfil Town Hall, located at 2101 Innisfil Beach Rd. Innisfil.

First and Last Name

Phone Number:

E-mail

Approximately how many Innisfil Transit trips do you make per month?

I acknowledge that upon receiving a test kit, I will be responsible for the following:

1. I will train myself on how to use the tests by viewing the self-collection training video and other materials available on the Ministry of Health website. The Town will provide links to training materials in a separate email to follow. 2. I will test myself twice weekly and report my test results as required by the Town of Innisfil. 3. If I test positive, I will report my positive result and immediately get tested using a confirmatory PCR test. If positive, I will remain self-isolated for a minimum of 10 days or as advised by the Public Health Unit. 4. I will use the tests for my own purposes only and they will not be sold to or used by anyone else.

I acknowledge that the the Town of Innisfil will be contacting me via email with information about how and when to pick up my rapid COVID-19 antigen test kit.

Yes

I acknowledge that the rapid COVID-19 antigen test kit will be available for pick up only at Innisfil Town Hall, located at 2101 Innisfil Beach Rd, Innisfil ON, and I will be responsible for picking it up.

Yes

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