Enter your organization name.
Enter your contact information, including your direct line phone number, to avoid delays should we need to contact you regarding details for your order.
Be sure to fill an appropriate shipping address (no PO Box address). Provide the name and phone number for the staff member responsible for receiving the shipment.
Provide details on the following: the name of the lab you are working with, the status of your outbreak (residents or staff?)
As a condition of receiving COVID-19 testing specimen collection supplies and/or laboratory services at no cost from the State of Wisconsin, you agree to:
You also agree not to: