Registration form for passing PCR-test in "Adonis" laboratory

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Please, fill up this form for passing PCR-test in laboratories only in Kyiv and representatives of laboratories will contact you as soon as possible. They will provide you with detailed information, prices and the instructions for passing test. Stay healthy ;)

Name and surname *

Date of birth *

YYYY

Age *

Gender *

Male

Female

Contact phone number *

Contact email *

Citizen of *

Documents *

Passport

Other document

Adress of living (Country, city) *

Did you visit countries of red zone for last 14 days/ do you live in red zone country? *

Yes

Have you had a contact with a laboratory confirmed Covid-19 patient? *

Yes

Indicate your arrival date to Ukraine *

YYYY

Indicate your departure date from Ukraine *

YYYY

Do you want pass a test in *

Kyiv, Zhilyanskaya st.72 (right bank)

Kyiv, Raisa Okipna 8-b (left bank)

Choose the format of the test you need (deadline for receiving the result) *

Receiving the result within 12 hours (passing only on Raisa Okipna Str.8-b)

Receiving the result within 18 hours (passing can be on 2 address)

Receiving the result up to 48 hours (passing can be on 2 address)

Do you agree to processing of your personal data and their transferring only to medical centers? *

Yes

Submit

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