You Are Almost Done! One Last Step ....

Fill in the form below and our customer representative will verify your eligibility. If you're eligible for a free Covid-19 tests, we will ship it right to your address. Please make sure you enter the correct information.

First Name

Last Name

Street Address

City

State

Zip Code

Date of Birth (MM/DD/YYYY)

Gender

Mobile Number

Email Address

Would You Like Us To Automatically Send Your Kits Each Month

PLEASE DO NOT SUBMIT AN ORDER IF YOU DO NOT HAVE MEDICARE OR DO NOT WANT TO PROVIDE YOUR MEDICARE NUMBER. This will allow us to process orders for those who needs this the most.

Note: Your Medicare ID determines your eligibility if you are qualified to receive the FREE Covid Test Kits.

By submitting, I give Express written consent authorizing Precision RX Pharamcy to be my preferred provider to receive my eight over the counter covid tests provided to Medicare Part B recipients, and to refill my monthly order on the beginning of each month throughout the emergency use mandate. I attest that I have not ordered similar or the same tests in the last month from any other provider for which the Federal Government was billed. I give consent to Precision RX Pharmacy and or associate entities to contact me in the future in reference to this program. I am not using these for employment or resale purpose. I am opting into to receive the allowable number of covid tests shipped each month to the address provided free of charge to me, according to the guidelines of President Joe Biden’s April 2022 mandate for Medicare Part B to cover the cost of at-home covid testing.

SUBMIT ORDER

Your information is 100% safe and secure. We do not spam or sell your information.