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Essen Health Care has set up a Screening Program for our patients who think they need to be tested for Coronavirus (COVID-19).  Testing is by appointment only and not everyone needs to be tested. Submit this form and one of our trained staff will call you and help determine whether or not you need to come in for testing.

Testing is appropriate if you are feeling sick with cough and fever, have been in contact with someone who has tested positive for COVID-19, or you have traveled internationally. If you have fever and cough, but are also short of breath or having trouble breathing, please call 911 (and inform 911 that you have risks for having coronavirus (COVID-19,) such as exposure to a known case or international travel.)

If you don’t need to be tested now, we can keep in touch with you to track your condition. That way, if things change, we can get you help right away. 

Select "Yes" ONLY if you have any of the following symptoms?

Cough*

Fever of 100 degrees or higher*

Traveled to COVID-19 exposed countries*

Do NOT have difficulty breathing but have flu-like symptoms*


If you did not select any of the above, please click here to book a regular appointment, else continue to book an appointment for Coronovirus testing and submit the form.

Patient Information

*Mandatory Fields

Birthdate:

Patient Contact Information

*Mandatory Fields


Health Insurance Plan

MANDATORY: Help speed up the Registration Process.

Download and fill out your forms before you come in for your appointment. It'll help speed things along.