Testing Form

Please select your tests from the following options:

More than one test may be selected.

Single Testing Prices

Covid-19 PCR Test - $300 (eligible for insurance coverage)
Covid Test - $60
Flu A/B Test - $60
RSV/hMPV Test - $60
Strep Test (tests for Strep A, C G) - $60
Flu A/B & RSV/hMPV combo - $100

If you need a Covid-19 test, please select one below:*

Covid-19 PCR Test (eligible for insurance coverage)

I don't require a Covid-19 test.

Do you need a Flu A/B test?*

Yes

No

Do you need a RSV/hMPV test?*

Yes

No

Do you need a Strep test?*

Yes

No

All testing services selected can be paid for at your appointment.

Additional Questions

Are you currently pregnant?*

Yes

No

Do you work in healthcare?*

Yes

No

Have you been tested previously for COVID-19?*

Yes

No

Do you work in a special setting where the risk of COVID-19 transmission may be high?*

Yes

No

Insurance Verification

Do you have health insurance?*

Yes

No

“Government funded Covid-19 testing for the un-insured ended on 3/22/22. Our PCR Testing will cost $130 (cash or card) for those without health insurance. Test costs not covered by a patients’ insurance or providing inactive/inaccurate health insurance information will result in a bill for testing performed.”

Please Provide Your Social Security Number.*

Needed for uninsured claim submission. Per the HRSA announcement on 3/16/22, government funded Covid-19 testing claim submissions ends for the uninsured on 3/22/22. Effective 3/18/22, Advanced Laboratory Services' PCR Testing will cost $130 (cash or card) for those without insurance. Providing inactive or inaccurate health insurance information will result in a bill for testing performed.

Are you the insurance policyholder?*

Yes

No

What is your Insurance Company?*

What is your Policy #?*

What is your Group #?*

Please provide the full name of the policyholder.

First Name*

Middle Initial*

Last Name*

What is the Date of Birth of the policyholder or responsible party?*

Who is the Insurance Company of the policyholder or responsible party?*

What is the Policy # of the policyholder or responsible party?*

What is the Group # of the policyholder or responsible party?*

What is your relationship to the insured?*

Spouse

Dependent

Please bring physical insurance card and Driver's License or other valid photo identification.

Schedule Your Appointment

Services*

Please select a location for your appointment in this dropdown menu. Different locations have different schedules.

Hidden

Location*

Sherman, TX: 500 E Peyton St, Suite 300, Sherman, TX 75090

Denison, TX: 2415 South Austin Ave., Denison, TX 75020

Calendar*

Please select a Location, then choose a date and time to schedule your appointment. Grayed out selections are unavailable or already scheduled. Confirm the date and time selected below the calendar. If you wish to choose another, simply click the "x" then make your selection again.

Sun	Mon	Tue	Wed	Thu	Fri	Sat
				1	2	3
4	5	6	7	8	9	10
11	12	13	14	15	16	17
18	19	20	21	22	23	24
25	26	27	28	29	30

Closed Saturdays until further notice.

Please select your tests from the following options:

General Information

Exposure

Symptoms Questionnaire

Medical Conditions

Additional Questions

Insurance Verification

Schedule Your Appointment

June 2023

Consent

Phone:
903-487-0598

Address:
500 E Peyton St, Suite 300 Sherman, TX 75090

Hours:
Mon. - Fri. 8:30am – 4:30pm
Sat. Closed
Sun. Closed

Closed Saturdays until further notice.

Testing Form

Please select your tests from the following options:

General Information

Exposure

Symptoms Questionnaire

Medical Conditions

Additional Questions

Insurance Verification

Schedule Your Appointment

June 2023

Consent

Phone:903-487-0598

Address: 500 E Peyton St, Suite 300 Sherman, TX 75090

Hours: Mon. - Fri. 8:30am – 4:30pmSat. ClosedSun. Closed

Phone:
903-487-0598

Address:
500 E Peyton St, Suite 300 Sherman, TX 75090

Hours:
Mon. - Fri. 8:30am – 4:30pm
Sat. Closed
Sun. Closed