Antigen Test For Travel
Location: Unit #24, 8707 Dufferin Street, Thornhill, Ontario, L4J 0A2
Name
*
First Name
Last Name
Email Address
*
example@example.com
Home/Work Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
*
Please enter a valid phone number.
Date of Birth
*
-
Month
-
Day
Year
Gender
*
Please Select
Male
Female
Prefer Not to Say
Identification Document
*
Please Select
Passport
Identification Number
*
One Way / Round Trip
*
Please Select
One Way
Round Trip
Antigen Test Option
Please Select
Virtual ($79+HST)
At Home ($149+HST)
Date of Departure
-
Month
-
Day
Year
Date
Date Of Arrival (Optional)
-
Month
-
Day
Year
Date
Appointment for Antigen Test
*
I certify that at this time I am asymptomatic.
Additional Notes
Book An Appointment
Should be Empty: