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Please fill out this form when you are in the drive-through line.

Covid-19 Test
Patient Registration Form

Patient Information

***We only accept Medicare and BCBS for non-established patients

Please have your Driver's License and Insurance Card ready to copy

Clinical Information

Reason for Testing

Symptoms Questionnaire - please select all tht apply

Have you been diagnosed with any of the following underlying conditions?

Taylorville Family Medicine
WINCHESTER SQUARE
7700 Hwy 69 S, Tuscaloosa, AL 35405

Sick Clinic at Bear Creek
TAYLORVILLE CORNERS
601 Bear Creek Rd. Tuscaloosa, AL 35405

7:00 AM - 7:00 PM

7:00 AM - 7:00 PM

7:00 AM - 7:00 PM

7:00 AM - 6:00 PM

7:00 AM - 5:00 PM

Closed

Closed

Monday             

Tuesday
Wednesday

Thursday

Friday 

Saturday          

Sunday         

Monday             

Tuesday            

Wednesday        

Thursday             

Friday               

Saturday          

Sunday              

7:30 AM - 7:00 PM

7:30 AM - 7:00 PM

7:30 AM - 6:00 PM

7:30 AM - 5:00 PM

7:00 AM - 5:00 PM

      Closed

Closed

  

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© 2024 by Taylorville Family Medicine

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