Baltimore Jewish Community Covid Testing Registration
AS OF JAN 1, 2021 THIS FORM IS NO LONGER USED. CLICK HERE FOR UPDATED FORM FOR ALL TESTING
All information is kept strictly confidential and is only shared as required by law.
What is your reason for being tested?
Possible exposure to Covid-19
Work-related or precautionary testing
Follow-up for previously testing positive
Are you testing as part of an organized business or group testing?
Please click here to use the form for business/group testing.
What are your symptoms? Check all that apply.
Fever or chills
Shortness of breath or difficulty breathing
Loss of taste or smell
Congestion or runny nose
Nausea or vomiting
When did your symptoms start?
Where might you have been exposed?
Event (wedding etc.) Exposure
Family Exposure (outside of home)
Which Shul did you attend?
Ahavas Yisroel Tzemach Tzedek (R' Heber)
Agudah (Park Heights)
Arugas Habosem (R' Taub)
Avodas Yisroel (R' Tesser)
Bais Haknesses Ohr HaChaim (R' Weiss)
Bais Lubavitch (Clarks Ln)
Bais Medrash of Ranchleigh (R' Naiman)
Beit Yaakov (R' Goldfeiz)
Beth Avrohom (R' Dovid Katz)
Greenspring Sefardic Center
Kehilath Bnei Torah (R' Seidmann)
Kol Torah (R' Berger)
Liberty Jewish Center
Machzikei Torah (R' Kostelitz)
Meor HaTorah (R' Wein)
Mercaz Torah & Tefilah (R' Eichenstein)
Mevakshei Torah (R' Millrod)
Ohel Moshe (R' Teichman)
Ohel Yakov (R' Akiva Feldman)
Shearith Israel (R' Hopfer)
Shomrei Mishmeres (R' Schwartz)
The Shul at Lubavitch (R' Kaplan)
Suburban Orthodox (R' Silber)
Tiferes Yisroel (R' Goldberger)
Other (Minyan not listed)