COVID-19 Test Prescreening Form

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

Is this about a child under the age of 2?

Are you an employee of Northern Light Health requesting testing for symptoms, an exposure, work clearance or surveillance?

Have you or the person you are inquiring about tested positive for COVID-19 within the past 90 days?

Did your provider order a COVID test for you?

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
  • Runny or stuff nose
  • Extreme tiredness
  • Nausea or vomiting
  • Diarrhea

Have you or the person you are inquiring about been in direct contact with a Covid-19 positive individual

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

Would you like to schedule a test for any other reason? (IT WILL TAKE 5-7 DAYS to get your results)

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 MAJOR symptoms?

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

Are you experiencing any of the following minor symptoms?

  • Headache
  • Nausea
  • Body ache
  • Fatigue

Are you seeking testing due to:

  • Return from Travel
  • Work Exposure
  • Community Exposure
  • Directed to test by employer

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

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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For ALL other employee testing requests - Please contact your local HR team

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Northern Light Health and the State of Maine are not currently testing for travel. Please contact Northern Light Pharmacy Click here

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

Pre Order

Please pick a Northern Light testing site to schedule your appointment.

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Blue Appointment

Please pick a Northern Light testing site to schedule your appointment.

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Yellow Appointment

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Yellow Appointment

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Orange Appointment

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Purple Appointment

Please pick a Northern Light testing site to schedule your appointment.

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Purple Appointment

Please pick a Northern Light testing site to schedule your appointment.

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Administrative Appointment

Please note, if you schedule an appointment for a COVID test through our app, you will need to pre-register for your appointment using Northern Light Health Pre-Registration.

Administrative Appointment

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

Pre-registration

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