COVID Antigen Test Form

COVID Antigen Testing Report


This form must be filled out the same day a COVID Antigen Test is taken by a ZPS employee to be reported to the State.

All fields are required. Including the Lot # on the test is very important. Included in the form are examples of a COVID test package and the Procedure Card for reference.

Do not submit this form until you have results of your test, but it must be submitted the same day the test is taken.

 All responses from this form will be kept confidential.  

Access the COVID ANTIGEN TEST FORM HERE.