Appointment Registration

Fill out the form below to register your appointment for Covid test

Appointment Date *

Time

Exam Type *

First Name *

Last Name *

Your Gender *

Date of Birth *

Country (Nationality) *

City *

Address *

Post Code *

Passport Number Or ID Number *

Social Security Number (AMKA) *

Mobile Phone Number *

Phone Number

Email *

Email (Confirm) *

Flight Date

Flight Time

Destination

Hotel Name

Hotel Room Number

Tour Operator

Notes

I agree with the collection and the processing of the sample for SARS Cov-2 (COVID-19) with the Real Time – PCR or Rapid Antigen Test. *