COVID-19 Home Test Kit Request

Have you or someone living in your household been affected by COVID-19?

This program will now provide home test kits for COVID-19 on request.

Fields marked with a red asterisk (*) are required.
Your Name*
First Last
Your Tribal ID Number (if available)
Your Current Mailing Address*
Please enter your physical mailing address, we cannot ship to a PO box.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Phone Number
Please enter a phone number you can be reached at.
Your Email Address
Please enter an email address you can be contacted at.
Number residing in household
How many people total live in your household?
Comments/Questions
CAPTCHA

If you have questions, please contact:
generalresources@snoqualmietribe.us