Get Va Covid-19 Testing Authorization Form - City Of Lynchburg 2020-2025

Filling out the VA COVID-19 Testing Authorization Form online can streamline the process of obtaining a COVID-19 test. This guide will walk you through each step to ensure that you complete the form accurately and efficiently.

Follow the steps to complete the authorization form online.

1. Click ‘Get Form’ button to obtain the form and open it in an editor.
2. Enter the date in the designated field at the top of the form.
3. In the section labeled 'City of Lynchburg employee', indicate the reason for requiring a COVID-19 test by completing the blank field.
4. Choose the test site by circling one of the options provided: Walk-In-Care-Wards Road or Walk-In-Care-Candlers Mountain. Make sure to include the location's corresponding address.
5. Fill out the employee's print name and signature on the lines provided.
6. Complete the employee's address, date of birth, and contact number accurately.
7. Provide the supervisor's print name and signature in the specified fields.
8. Fill in the employer's designated point of contact, including their phone number and email address.
9. If the testing charges are to be billed to the City of Lynchburg for self-pay, mark the appropriate option.
10. Finally, ensure all information is complete, then save your changes. You can download, print, or share the form as needed.

Complete your VA COVID-19 Testing Authorization Form online today!