Sacred Heart Church

Sacred Heart Church 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.

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

IMPORTANT: Be on time – Please wait in your car and have a Valid Cellphone Number and be ready so we can call you inside when it is your turn to be tested. Make sure the phone number is the same number you put on the registration form.

 

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.

Sacred Heart Church

12 Terrace Avenue

Rochelle Park, NJ

 

COVID-19 Testing,
Sunday, February 14 , 2021 – 1:00 pm – 3:30 pm

WALK‐IN ‐ TESTING EVENT
FOR THOSE WITH OR WITHOUT SYMPTOMS

Name DateTime Action
Sacred Heart ChurchSunday, February 1401:00 PM to 01:30 PMCheck Availability
Sacred Heart ChurchSunday, February 1402:00 PM to 02:30 PMCheck Availability
Sacred Heart ChurchSunday, February 1401:30 PM to 02:00 PMCheck Availability
Sacred Heart ChurchSunday, February 1402:30 PM to 03:00 PMCheck Availability
Sacred Heart ChurchSunday, February 1403:00 PM to 03:30 PMCheck Availability

Wellcare COVID-19 Testing Service

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