Fit-to-Fly Certificate form
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
NHS GP Details
*
Current Symptoms:
*
Reason for Covid-19 Testing
*
Identification Document (Passport, ID, or Drivers license)
*
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of
Photo/Video of Blank Test Cassette (Before taking your test)
*
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of
Photo/Video of Test Cassette with Results (After taking your test)
*
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of
Submit
Should be Empty: