PCR Test Collection

Witmer - Chapin

Kindly complete the form below and upload your PCR test results. Kindly note that the PCR test must be taken between Monday, September 20th and Wednesday, September 22nd.

Results must be uploaded by noon on Thursday, September 23rd.

If you are being tested with Everpoint Health in Nantucket, you do not need to complete this link.

PLEASE DO NOT RE-SUBMIT. Once submitted, you will  receive an email confirmation. If you do not see the e-mail, kindly check spam.


If you have any trouble, please contact Erica at etripodi@everpointhealth.com or 203-517-7687.


This form is secure and HIPAA-compliant .

Guest Information
Personal Information:
PCR Test Result Upload
Upload File
Patient Consent

By checking the general consent box below, I certify that I am either (1) at least 18 years of age or (2) I am legally recognized as an ‘emancipated minor’ by the state in which I reside or (3) I am the parent or legal guardian of the minor on behalf of whom the test result is provided.


I hereby authorize Everpoint Medical, PLLC / Everpoint Health, LLC to disclose this information to my event host. The purpose of this disclosure is to provide information to the above listed individual/entity for infectious disease management.  I understand that I may refuse to sign this authorization.

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