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Concierge Swabbing
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What test would you like?
Rapid Antigen Test (Lateral Flow)
RT - PCR Test
Both above
Clear selection
Date Requested for Test
MM
/
DD
/
YYYY
Last Name
Your answer
First Name
Your answer
Passport Number or National Identification
Your answer
Passport Country
Country of Issue e.g. USA, UK, Barbados, Australia, Grenada
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age
Your answer
Sex
Male
Female
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Contact number 1 (with Whatsapp Preferred)
Your answer
Alternative Contact Number (Optional)
Your answer
Email Address
Your answer
Address of stay
Home/Hotel/Transit/Cruise Ship
Your answer
Reason for Testing
Travel
Medical Procedure/Admission
Return to work/School
Just Checking Status
Contact with Positive case
Event/Conference
Other:
Clear selection
If applicable - Date of Travel
MM
/
DD
/
YYYY
If Applicable - Time of Departure
Time
:
AM
PM
Any Special Requests?
Your answer
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