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Crossroads COVID-19 Test Submission
Form to submit COVID-19 test results:
Child's Name
Date and Time of COVID-19 Test
Date and Time of COVID-19 Test: Date
Date and Time of COVID-19 Test: Time
Type of test
- Select -
Home Administered Antigen
Clinically Administered Antigen
Clinically Administered PCR
Test Result
- Select -
Negative
Positive
Upload clinical test report or photo of completed home test
One file only.
8 MB limit.
Allowed types: gif, jpg, png, svg, pdf, jpeg.
32 MB limit per form.
Notes
Leave this field blank
