COVID-19 Rapid Test Inquiry Testing Makes Everyone Feel Safer Email Name Phone Number Your Company Name Type of Organization Company (medical related) Company (non-medical) End-User of the Rapid Test Other Department or Position in Company Full name and email of the person that referred you to this page Are you the decision-maker to authorize the purchase of Rapid Testing Kits for your company? Yes No How many COVID-19 Rapid Antibody Tests do you want to purchase? How many COVID-19 Rapid Antigen Tests do you want to purchase? Where will the tests be shipped to? (State/Country) Can you provide a POF (proof of funds) to confirm your order if requested? Yes No Are you willing to wire all of the funds for the purchase price of the COVID-19 Rapid Tests into an escrow account to secure the order if required? Yes No By what date do you need to receive these tests? Comments or additional information: Submit Return to Home Page