113 W Sycamore Street, Attica, IN 47918 (877) 339-9567 (765) 762-3035

Search for:

Home
Services
Community Resources
News
- Opioid Awareness
Contact

Application for Testing

Step 1 of 2

50%

Name of Contact*
First Last
Contact Phone*
Contact Email*
Confirm Email*

Name of person being tested:*
First Last
Address of person being tested:*
Street Address Address Line 2 City State ZIP Code
Age of person being tested:*
Please enter a number from 1 to 99.
Workplace/School of person being tested:
Do you have other chronic medical problems such as heart or lung disease, cancer, a weak immune system, or other high risk conditions?*
- Yes
- No
How Many Days Sick?*
Please enter a number from 1 to 99.
Fever over 100.5?*
- Yes
- No
Cough?*
- Yes
- No
Suspected COVID-19 Contact?*
- Yes
- No
Are you testing to have early release from quarantine?*
- Yes
- No
On what day will you reach your 7th day of quarantine?
Date Format: MM slash DD slash YYYY
CAPTCHA

Contact Us

Phone:
(877) 339-9567
(765) 762-3035

Address:
113 W Sycamore Street
Attica, IN 47918

General Questions:
FWHealthdept@gmail.com

Coronavirus/COVID-19 Questions:
FWHealthCOVIDQuestions@gmail.com

Hours of Operation

Monday:8:00 a.m. - 4:00 p.m.
Tuesday: 8:00 a.m. - 4:00 p.m.
Wednesday: 8:00 a.m. - 4:00 p.m.
Thursday: 8:00 a.m. - 4:00 p.m.
Friday: 8:00 a.m. - 4:00 p.m.

Closed Saturday & Sunday

Closed Noon to 1:00 p.m. and all major holidays

Office

Our Location

© Copyright 2021. Fountain & Warren County Health Department. All rights reserved. Privacy Policy | Sitemap | Website Developer

Home
Services
Community Resources
News
- Opioid Awareness
Contact

Skip to content

Accessibility Tools

Increase Text
Decrease Text
Grayscale
High Contrast
Negative Contrast
Light Background
Links Underline
Readable Font
Reset