Advance Beneficiary Notice

Anyone have an advance beneficiary notice they could share? We perform molecular Flu, Strep, RSV, and COVID testing here in the office but it is a non covered benefit for some of our insurance plans. Patients have been asking to pay out of pocket for the rapid testing so would like to have an ABN in place for these instances. I have seen the Medicare ABN template but would love to have a pediatric friendly one. Thank you!