Day 2 Antigen Clinic
Purchase Day 2 PCR - In-Clinic Test
Please call us to book an appointment on 01234 711976. Same day results avaliable
Personal information
Date of Birth
Ethnicity
English, Welsh, Scottish, Northern Irish or British
Irish
Gypsy or Irish Traveller
Any other White background
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed or Multiple ethnic background
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
African
Caribbean
Any other Black, African or Caribbean background
Arab
Any other ethnic group
Gender
Male
Female
Contact Information
Tick if you
do not
want confirmation emails sent directly to the client.
Note: Alternative Email is required which, will receive email correspondance
Your Address
Tick this box if this is
not
the same address you will be staying at during your self-isolation period.
Address for self-isolation.
Tick this box if
billing
address is
not
the same as your address
Billing Address
Passport
Vaccination
Have you had your vaccination:
Please select
Yes
no
Flight Information
The date of your arrival in the UK
Date of Departure from non-exempt country
Did you fly through another country?
Tick this box if you
have
transited through another country
When will you be doing the test?
Select today if unknown
Results time. Please make sure you have booked an appointment
Please select
£75: 24 hours
£100: Same day
Same day results are avaliable if the test is done before 3pm. Please call 01234 711976 to book an appointment.
Please make sure your email address and phone number are correct otherwise you will not receive a code for your passenger locator form
Submit