Monroe County, NY COVID-19 Testing Registration Form

PRE-REGISTRATION ENCOURAGED! WALK-INS WELCOME.

Children under 1 year old are ineligible to receive a test at our facilities.
Individuals under 18 MUST have a parent/legal guardian with them to consent in person with acceptable ID - Driver's ID, Passport, State Non-Driver's ID, Medicaid Card (with photo), School ID (with photo), or Work ID (with photo).

* Required Fields

Confirmation of appointment will be sent to this email.
Available date/time Unavailable Selected

Person

This email address will receive notification of test result.
If this person needs special accommodations please indicate above.
School/Employer Info
YOU WILL NOT BE ABLE TO EDIT THIS INFORMATION AFTER CLICKING THE SUBMIT BUTTON BELOW. PLEASE MAKE SURE ALL INFORMATION IS CORRECT.