Workplace Screening Programme request form
The Guernsey Chest and Heart is dedicated to supporting your company look after your team’s health. If you would like to book your team’s workplace screening, please complete the short form below. After filling in the form please press the 'submit' button, we will then be in contact to arrange your workplace screening programme.
Company Name
*
Contact Name
*
First Name
Last Name
Email address
*
Phone Number
*
Please enter a valid phone number we can you to contact you
Type of workplace screening
Wellbeing Screening - £350 per 12 staff screened
Healthy Heart Screening - £700 per 12 staff screened
Bespoke Screening – some companies wish to have a set number of both screening programmes for their teams. Screening fee discussed on application.
Notes from request organisation
Please use the above box to add any additional information - if required.
Data protection notice
Data collected within this form will be stored in accordance with our Data Protection Policy, which is available to view upon request. Further information relating to the relevant policies can be viewed on our website - www.chestandheart.org.gg.
Submit
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