Bernards Township COVID-19 Testing Registration Form

Pascack Valley Regional High School District
COVID-19 Testing Registration Form

 

Please fill out the following information to complete your registration. With medical insurance, there is no cost to you for the COVID-19 test. We will only perform diagnostic medical services covered by your medical insurance. You will receive a statement from your insurance company – an explanation of Benefits (EOB) – which will itemize the services received, but it is not a bill. At this time, we are not able to support self-pay registrations.

Please note that all participants are required to arrive at the test location wearing a mask during your scheduled date and time. For support with this form only, contact wellcarecovidtesting@gmail.com.

 

Save Time In LineDownload and fill out these 2 forms and bring them along with you to your test.

1. Assignment of Benefits Form [PDF]
2. Covid Specimen Intake Form [PDF]

Uninsured, Please Note:

Due to the lack of sufficient funding for the HRSA COVID-19 Uninsured Program, our COVID-19 testing clinics will bill individuals without health insurance $75 per COVID-19 test.

(201) 358-7006

Pascack Valley Regional High School District

Hillsdale School District

Woodcliff Lake School District

Demarest

Emerson

 

COVID-19 Testing – Walk-Up Event
Thursday October 28, 2021 – 03:30 pm – 5:30 pm

Name DateTime Action
PascackThursday, October 2803:30 PM to 04:00 PMCheck Availability
PascackThursday, October 2804:00 PM to 04:30 PMCheck Availability
PascackThursday, October 2804:30 PM to 05:00 PMCheck Availability
PascackThursday, October 2805:00 PM to 05:30 PMCheck Availability

Wellcare COVID-19 Testing Service

WellCare provides New Jersey Municipalities and Institutions with free COVID-19 Testing Services.