COVID-19 Day 2 & Day 8 Test Pack

COVID-19 Day 2 & Day 8 Test Pack

19 Kensington High Street, London, W8 5NP
- Day 2 & Day 8 Test PackDay 2 & Day 8 Test Pack + Test-To-Release
- Yes (Results in 3 Hours)No (Results in 24 hours)
- YesNo
- Fit-to-Fly PCR TestFit-to-Fly Antigen Test
- Yes (Results in 3 Hours)No (Results in 24 hours)
- Patient Name*
  
  First NameLast Name
- Date of Birth*
  
  DayMonthYear
- MaleFemale
- Country of Residence*
- Ethnicity*
- Passport Number*
- Are you Vaccinated
- Address (Where you will stay in the UK)*
  
  Street Address
  
  Street Address Line 2
  
  CityTown / County / Province / State
  
  Post CodeCountry
- Contact Number*
- Email*
- Date & Time of Your Arrival In The UK*
  
  DayMonthYear
- Country You Are Arriving From*
- Flight / Train / Vessel Number*
- Flight Day*
  
  DayMonthYear
- Consent
  
  By continuing with your booking you understand that you must not attend if you're presenting any COVID-19 symptoms including a temperature above 37.8°C, a persistent cough or have difficulties breathing. You may attend the centre once your symptoms have resolved and/or you have completed self-isolation for 10 days.
- I, the above-mentioned patient, I hereby agree and confirm that the information provided in this request form is true and complete. I authorise Prince Pharmacy to forward the related information to governmental agencies if required to do so. I agree to self-isolate until my test is completed. If I test positive, I adhere to the current government guidelines relating to the COVID-19.Let's keep in touch! Would you like to receive information and promotions from Prince Pharmacy?
- - Internal Use -
  
  Test Appointments & Certificates
- 160 Edgware Road, London, W2 2DS99 Edgware Road, London, W2 2HX40 Knightsbridge, London, SW1X 7JN19 Kensington High Street, London, W8 5NP
- Fit-to-Fly Test Appointment Slot
  
  DayMonthYear
  Date
  Hour Minutes
- Test-to-Release Appointment Slot
  
  DayMonthYear
  Date
  Hour Minutes
- Test Time & Date
  
  DayMonthYear
  Date
  Hour Minutes
- Report Issued
  
  DayMonthYear
  Date
  Hour Minutes
- NEGATIVEPOSTIVE
- NOT DETECTEDDETECTED
- NONE REPORTEDOther
- YesNo
- Randox360
- D2/D8 Provider Cal
- TDLRandox360
- FTF Provider Cal
- qrcal
- Package Calculation
- Email Add. Tests
- YesNo
- Certificate Number
- Unique Reference Number
  Booking Reference Number
- TTR Cert.
  
  Cancelof
- FTF Cert.
  
  Cancelof
- Day 2 Cert.
  
  Cancelof
- Day 8 Cert.
  
  Cancelof
- Should be Empty:

COVID-19 Day 2 & Day 8 Test Pack

Consent

- Internal Use -