COVID-19 Test Prescreening Form

Are you or the person you are inquiring about in medical distress?

Have you tested positive for COVID 19 within the past 90 days

Are you an employee of Northern Light Health?

Are you returning from travel outside of Maine?

Are you seeking testing BEFORE traveling outside of Maine?

Have you been in direct contact with a known COVID-19 positive individual?

Is this about a child under the age of 2?

Are you a healthcare worker or first responder ( e.g. Active Military, EMS, Police, Fire, etc)?

Do you live in group housing (e.g. Long Term Care, group home, assisted living or shelter)?

Please be sure to bring your work badge to verify your employment.

Are you or the person you are inquiring about wanting testing due to traveling outside of the state of Maine?

Are you or the person you are inquiring about having any of the following symptoms?

  • Cough
  • Shortness of breath
  • Fever
  • Chills
  • Muscle or body aches
  • Sore throat
  • New loss of taste/smell
  • Headache
  • Congestion
  • Runny nose
  • Extreme tiredness
  • Nausea or vomiting
  • Diarrhea

Do you or does the person you are inquiring about have chronic medical conditions and/or are age 65 or greater?

  • Lung disease
  • Cancer
  • Heart conditions
  • Cerebrovascular disease
  • Kidney disease
  • Liver disease
  • Diabetes
  • Immunocompromising conditions
  • Overweight
  • Smoker
  • Sickle cell disease
  • Pregnancy

Are you experiencing any of the following minor symptoms?

  • Headache
  • Nausea
  • Body ache

Have you had the COVID vaccine in the last 3 days?

Are you experiencing any of the following major symptoms?

  • Diarrhea
  • Loss of taste/smell
  • Shortness of breath
  • Fever of 100.0 F or higher
  • Cough
  • Runny nose
  • Sore throat
  • Vomiting
  • Congestion

At this time a testing is not recommended. For additional information please visit the CDC website at www.cdc.gov/coronavirus.

Would still like to be tested?

Yes

Have you been in direct contact with a known Covid 19 positive individual?

Please call 911 to be evaluated by your nearest emergency department.

At this time a testing is not recommended. It is recommended to call your Primary Care Provider if you are currently having symptoms or other concerns..

Exposures to COVID positive individuals must be disclosed directly to human resources, who will provide guidance on appropriate quarantine guidelines. Please do not report to work, but contact your local Human Resources (HR) department immediately. You must be cleared following an exposure through HR and cannot utilize a test or attestation for this purpose.

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This tool does not contain the answer to your specific question, as it is related to employee testing. Please contact your local Human Resources department.

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Please contact your local HR team. This screening tool is for symptomatic employees only.

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Please call the preferred provider for this child to arrange for care.

Blue Appointment

Please select a Northern Light testing location near you:

Please remember to pre-register for your visit after signing up for your COVID19 test appointment. Click Here

Yellow Appointment

Please select a Northern Light testing location near you:

Please remember to pre-register for your visit after signing up for your COVID19 test appointment. Click Here

Yellow Appointment

Please select a Northern Light testing location near you:

Please remember to pre-register for your visit after signing up for your COVID19 test appointment. Click Here

Orange Appointment

Please select a Northern Light testing location near you:

Please remember to pre-register for your visit after signing up for your COVID19 test appointment. Click Here

Purple Appointment

Please select a Northern Light testing location near you:

Please remember to pre-register for your visit after signing up for your COVID19 test appointment. Click Here

Purple Appointment

Please select a Northern Light testing location near you:

Please remember to pre-register for your visit after signing up for your COVID19 test appointment. Click Here

Pre-registration

Please remember to pre-register for your visit after signing up for your COVID19 test appointment.
Click Here

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