WALK -IN CLINIC

Family Health Connection

 Phone: 410 -465 -5451

        443 280 2407

 M-F 9AM -  6PM

SAT-10 AM-3PM

Fax: (240)-713-3512

9055 Chevrolet Drive Suite 205

Ellicott City, ​MD 21042

COVID-19 Screening Questionaire

FAMILY HEALTH CONNECTIONS

( if you don't have please enter cash or your SSN)
Have you traveled to the following countries in the past 45 days (check all that apply)*
Have you had close contact (being within 6 feet or that person for an extended amount of time) with a confirmed case of COVID-19 in the past 45 days?
Has a Public Health Official communicated that you were potentially exposed to COVID-19?
Have you had any of the following symptoms over that past 30 days? *
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On The Day of Testing For Covid -19

Dear Clients

When you submit your questionnaire you can drive down to our address at your appointment date and time. and park at the front parking lot and give us a call to check in. We are open 8.30 am to 5pm Monday through Saturday.


 You will also get an email from our office to fill out  an Intake form   you will  be required to take a picture of front and back  of  your insurance card and submit  with your intake form you are filling out.

Please be advised that you have to contact the laboratory directly to get your

results if you are tested for COVID -19 in our facility. Due to the increasing number of testing we do daily, we are not able to notify

everyone who has tested negative or needs documentation for work, school or travel. You have to contact the laboratories directly to get your

results. DO NOT CALL OUR OFFICE FOR RESULTS.

When you arrive for testing, find a space and park in front of the building. There is usually a clipboard in front of the building towards the door entrance at your left. Pick one lab slip per person being tested and

fill out the upper top right corner for QUEST DIAGNOSTICS

laboratory or the highlighted areas for ACUTIS and LABCORP

laboratories. Please be sure to write your name, date of birth, address, email, phone number and more importantly your insurance

information CLEARLY!

Call 410 465 5451 when you are done filling out the lab slips. The testing is done inside your car in the parking lot.

IF YOU DO NOT HAVE INSURANCE BE SURE TO PUT YOUR SOCIAL SECURITY NUMBER ON THE LAB SLIP. FAILURE TO PROVIDE THESE INFORMATION WILL DELAY PROCESSING OF YOUR SPECIMEN AND CONSEQUENTLY DELAY YOUR RESULTS!

The nurse practitioner will see you and collect the specimen

Please NOTE the laboratory where your specimen is sent to by the lab slip you filled out and again CONTACT THEM DIRECTLY FOR YOUR RESULTS WITHIN 2-3 DAYS.

DO NOT CALL OUR FACILITY FOR RESULTS. WE WILL CALL YOU IF YOU TESTED POSITIVE ONLY.

THANKS IN ADVANCE FOR YOUR MAXIMUM CO OPERATION

QUEST DIAGNOSTICS -866 697 8378 and download MYQUEST APP. Your result will be made available to you in the app when it is ready.

ACUTIS-844 522 8847

LABCORP- 800 - 845 6167 and go to their website and create a PATIENT PORTAL and you will be able to access your results when it is ready.

Please contact your primary care for work slips or excuse duty slips.

Thank you very sincerely!

TESTING CENTERS - Security blvd and East Columbia Library

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