Working Hours

7 Days a Week

Location

Butternut Lane, NY

Hotline

305-644-4022

COVD-19 Rapid Test

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COVID-19 Testing Form

COVID-19 Testing Form

NEW Patient intake. Please fill out to the best of your abilities, you can always make changes at the front desk.

Peace Of Mind Med Center
2140 w flagler st suite 211
Miami, Fl. 33135
(305) 644-4022
Medical Director:
Deepan Mathur
Appointment Time *
:

During week days after 2pm please call for appointment available slots!

Home Address *
Home Address
Street Address
Street Address Line 2
City
State/Province
Zip/Postal
The reason for testing today (check all that apply) *
Please state if you have tested positive for COVID-19 in the past *
Are you currently experiencing symptoms (cough, shortness of breath, fever) *

* ANY PAYMENTS MADE TO US MAY BE REIMBURSED BY YOUR INSURANCE PROVIDER

Please choose a test option below: YOU MAY BE REIMBURSED BY YOUR INSURANCE PROVIDER FOR ANY PAYMENTS *
Total

Maximum upload size: 30MB
Maximum upload size: 40MB
Maximum upload size: 20MB
Checkboxes
You agree that you are not obligated to test at our center, and understand that we are a private practice charging seperatly for testing. Your insurance will pay the labs directly as we collect your insurance information, your payment to us is NOT a co-payment or deductible of any sort.

If you choose to do a standard PCR(nasal swab test) results may take longer than told wait times by the staff as covid testing surge in deferent time waves. You also agree that if results take longer than told time of 3-7 days you will not claim a charge back on your credit card nor are entilted to a refund as our services we conducted and fully rendered for your payment.

You agree to allow us to send you via text and or email important medical updates and current news related to you as a patient. no results or disclosed medical information will be sent via text only through email upon verification via telephone.

Rapid test Results are for the detection of SARS CoV-2 antibodies. IgM and IgG antibodies to SARS-CoV-2 are generally detectable in blood several days after initial infection, although the duration of time antibodies are present post-infection is not well characterized. Individuals may have detectable virus present for several weeks following seroconversion.

Laboratories within the United States and its territories are required to report all positive results to the appropriate public health authorities.

The sensitivity of COVID-19 IgG/IgM Rapid Test Cassette early after infection in unknown. Negative results do not preclude acute SARS-CoV-2 infection. If acute infection is suspected, direct testing for SARS-CoV-2 is necessary.

False positive results for COVID-19 IgG/IgM Rapid Test Cassette may occur due to cross-reactivity from pre-existing antibodies or other possible causes. Due to the risk of false positive results, confirmation of positive results should be considered using second, different IgG or IgM assay.

The COVID-19 IgG/IgM Rapid Test Cassette is only for use under the Food and Drug Administration’s Emergency Use Authorization. You also agree to receiving text messages from CIMA Med for occasional updates.

For More informtion about testing please visit: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html

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