COVID-19 Testing Request

This form is not to request antibody testing.

This form is solely used by NH Homeland Security and Emergency Management to coordinate the scheduling of COVID-19 testing in conjunction with the New Hampshire National Guard. Your information will be kept confidential and only used for diagnostic and tracking purposes. In filling this form out you are voluntarily sharing this information for the purpose of your sample collection. Information on this site will be shared with the New Hampshire Division of Public Health Services for public health purposes.

NOTE: Additional information regarding COVID-19 Testing is available in the NH DHHS Health Alert Network Message #15. Please review this link for additional testing sites that are not listed as options below.