COVID-19 TESTING REGISTRATION

Please complete the form below to register online for COVID-19 testing through UMC.

To expedite the registration process, please enter your name and date of birth exactly as they appear on your ID.

As a helpful reference for reading your test results:
Not Detected = Negative
Detected = Positive
A UMC clinician will call you within 72 hours if your result is positive.

PATIENT INFORMATION
Last Name: * First Name: *
Phone #: * Date of Birth: * MM/DD/YYYY
Employee ID#: Employer Name:
 
INFORMED CONSENT

Please read the "Informed Consent for COVID-19 Diagnostic Testing" document. Clicking this link will open the document in a separate browser tab.

Acknowledgment

For assistance with UMConnect or the MyChart app, please call 702-789-5160.

To speak with a UMC representative, please call 702-383-2619.

To submit this form and continue the scheduling process, please click the "Schedule your COVID-19 Test" button below.

In order to schedule your test, you must provide a nine-digit unique identifier. This number is used to uniquely distinguish you from other patients and to protect your identity. If you do not use your Social Security Number, please use another nine-digit number that is easily remembered. This number should be written down or retained in the event you need it at a later time.