Step 1 - Complete Form
Step 2 - Make Payment
Fit-to-fly rapid antigen test
(results within 15 minutes)
£37.50 per test
Your Travel Details
Depature Location*
Which Country you are travelling to? *
Depature Date*
Select depature date
Sunday 3rd of July 2022
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Depature Time *
Select depature time
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00:15
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00:45
01:00
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23:45
Who requires a test?
Traveller 1 Name *
Traveller 1 Date of Birth *
DD/MM/YYYY
Traveller 1 Gender *
Male
Female
Traveller 1 Ethnicity *
Select Ethnicity from list
WHITE
WHITE AND ASIAN
WHITE AND BLACK AFRICAN
WHITE AND BLACK CARIBBEAN
WHITE BRITISH
WHITE IRISH
WHITE OTHER
BANGLADESHI
BLACK - AFRICAN
BLACK - CARIBBEAN
BLACK - OTHER
CHINESE
INDIAN
PAKISTANI
ISC - UNSPECIFIED
ANY OTHER ETHNIC CATEGORY
ANY OTHER MIXED GROUP
OTHER / MIXED
UNKNOWN
Traveller 1 Passport Number *
Traveller 2 Name *
Traveller 2 Date of Birth *
DD/MM/YYYY
Traveller 2 Gender *
Male
Female
Traveller 2 Ethnicity *
Select Ethnicity from list
WHITE
WHITE AND ASIAN
WHITE AND BLACK AFRICAN
WHITE AND BLACK CARIBBEAN
WHITE BRITISH
WHITE IRISH
WHITE OTHER
BANGLADESHI
BLACK - AFRICAN
BLACK - CARIBBEAN
BLACK - OTHER
CHINESE
INDIAN
PAKISTANI
ISC - UNSPECIFIED
ANY OTHER ETHNIC CATEGORY
ANY OTHER MIXED GROUP
OTHER / MIXED
UNKNOWN
Traveller 2 Passport Number *
Traveller 3 Name *
Traveller 3 Date of Birth *
DD/MM/YYYY
Traveller 3 Gender *
Male
Female
Traveller 3 Ethnicity *
Select Ethnicity from list
WHITE
WHITE AND ASIAN
WHITE AND BLACK AFRICAN
WHITE AND BLACK CARIBBEAN
WHITE BRITISH
WHITE IRISH
WHITE OTHER
BANGLADESHI
BLACK - AFRICAN
BLACK - CARIBBEAN
BLACK - OTHER
CHINESE
INDIAN
PAKISTANI
ISC - UNSPECIFIED
ANY OTHER ETHNIC CATEGORY
ANY OTHER MIXED GROUP
OTHER / MIXED
UNKNOWN
Traveller 3 Passport Number *
Traveller 4 Name *
Traveller 4 Date of Birth *
DD/MM/YYYY
Traveller 4 Gender *
Male
Female
Traveller 4 Ethnicity *
Select Ethnicity from list
WHITE
WHITE AND ASIAN
WHITE AND BLACK AFRICAN
WHITE AND BLACK CARIBBEAN
WHITE BRITISH
WHITE IRISH
WHITE OTHER
BANGLADESHI
BLACK - AFRICAN
BLACK - CARIBBEAN
BLACK - OTHER
CHINESE
INDIAN
PAKISTANI
ISC - UNSPECIFIED
ANY OTHER ETHNIC CATEGORY
ANY OTHER MIXED GROUP
OTHER / MIXED
UNKNOWN
Traveller 4 Passport Number *
Your Personal Details
Contact Number *
Email Address *
Home Address *
Address 1
Address 2
Town
County
Postcode
Consent To Test
By ticking this checkbox I give consent to this test being done, or if this test is for a child, I confirm I am a legal guardian of the child and consent to this test being done.
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