Pre-Arrival Testing: Where should your kit be mailed?

On May 19, NYS released INTERIM GUIDANCE FOR CHILD CARE, DAY CAMP, AND OVERNIGHT CAMP PROGRAMS DURING THE COVID-19 PUBLIC HEALTH EMERGENCY which includes a requirement for prearrival testing of residential (overnight) campers within 72 hours of arrival at the camp.

Cornell Cooperative Extension / NYS 4-H Camps will require prearrival PCR testing of all staff and overnight campers, regardless of vaccination status.

Through the coordination of the NYS 4-H Office, we have contracted with Grapefruit Testing LLC to administer a testing program for our campers.

First Name of Camper/Staff being tested

Last Name of Camper/Staff being tested

Date of Birth

Camper's date of birth.

Email Address

Phone Number

Camp Arrival Date

Camp Arrival Date (second week, if applicable)

Insurance Information (Required)
NOTE: If your camper does not have insurance, Grapefruit Health will require their social security number (securely stored in their HIPAA compliant electronic health record system) NOTE: this is needed for those without insurance for compliance with the CARES Act). Please contact them directly at 646-653-2262 to provide that information or complete this form directly through them at https://form.jotform.com/211234931188151

Name of Insurer (if you don't have insurance please type NONE)

Group ID Number

If you don't have insurance, please type NONE

Insurance Subscriber Name

If you don't have insurance, please type NONE

Insurance Subscriber Phone Number

Subscriber Date of Birth

If you don't have insurance, please enter today's date.

Relationship to Insurance Subscriber (parent, self, etc)

Subscriber/Member ID number

If you don't have insurance, please type NONE

Responsible Party Full Name (if different than subscriber) This is almost always the same person as your subscriber. If it is not the same person as above please note their name, Date of birth, and relationship to them below