Test Order – Temporary – Inspire Diagnostics

COVID-19 Testing for a Return to Normal Life

Convenient tests wherever and whenever you need it.

If you are a Disney Cruise Line customer, please log into your Safe Passage portal to place an order for home kits or to make an on-site test reservation.

Order Your At-Home Test

Step 1 of 2

Personal Information

Name*

First Last

Date of Birth*

Demographic

Sex

Race

Ethnicity

Mailing Address

Note: We cannot deliver to PO boxes

Address*

Street Address Address Line 2 City State ZIP Code

Contact Information

Email*

Enter Email Confirm Email

Mobile Number*

Insurance Information

Type of Insurance

Private

Medicare

None

I would like to purchase my test kit

Private Insurance

First and Last Name of Insured

First Last

Insurance Company

Policy Number

Group Number

Upload image of insurance card

Max. file size: 10 MB.

Medicare

First and Last Name of Insured

First Last

Policy Number

No Insurance

I do not currently have any type of medical insurance

Agree

Upload image of Drivers License or ID

Max. file size: 10 MB.

Purchase PCR Home Test Kit

At Home PCR Test Kit

Price: $119.00

Total

Credit Card

Card Details

Cardholder Name