I hereby give consent for my personal information
related to my COVID-19 Assessment.
By submitting my email address and mobile number, I
consent to receive email and SMS communication (mobile messaging rates may apply) from
I understand that the MMRI Rapid Testing does not
accept medical insurance. Payment in the form of a
credit card hold is required at the time of
registration and the card will be charged once the
results are delivered. No show will incur an
administrative fee of $25.00.
I understand that the results will be reported to New York State Department of Health.