Request Your EKG

Request a copy of your child’s EKG

If your child HAS ALREADY BEEN TESTED at a PREVIOUS EKG SCREENING by the Max Schewitz Foundation, you can order a digital copy of your child’s EKG to be sent to you by email for a $15 handling fee. (This form is NOT for upcoming screening registration.) Payments can be made throught PayPal (choose this to also pay by Debit/Credit Card).

PAY WITH PAYPAL OR DEBIT/CREDIT CARD

Complete the form below, once you click SUBMIT, a Paypal link will display to facilitate payment of the $15 handling fee.

Please note: EKGs provided prior to the 2014/2015 school year were most likely completed on paper and have been shredded.