Covid test – Roshni Clinic

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Home
Covid
Services
Locations
Register
Check Results
Contact
More
- News
- FAQs
- Our Team

0

Day 2/8 PCR Test Order Form

1Test Kit's Required

2Complete Form

3Make Payment

Hidden
Test Type
Test*
- In Clinic
- Postal
Location
Please Select Days*
- Day 2 (£60)
- Day 2 SAME DAY (£100)
- Day 2 and Day 8 (£120)
Please Select Days*
- Day 2 (£60)
- Day 2 and Day 8 (£120)
- Day 2, 5 and 8 (£150)
Please Select Days*
- Day 2 (£60)
- Day 2 and Day 8 (£120)
- Day 2, 5 and 8 (£150)
Please Select Days*
- Day 2 (£30)
Please Select Days*
- Day 2 (£20)
Please Select Days*
- Day 2 (£25)
Include
- PCR before departure
Please select how many people will be returning to the UK and require testing
Person*
- People 1
- People 2
- People 3
- People 4
- People 5
- People 6
- People 7
- People 8
- People 9
- People 10

Total
Price: £ 0.00
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day
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pcr
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day_5
Order Day 2 and 8 COVID 19 PCR TESTS - £ 195.00(includes x2 tests)
You MUST order before arriving in the UK
Section 1 of 3 - Your Travel Details
Which Country you are travelling from? **
Date of arrival in the UK*
DD slash MM slash YYYY
Hidden
If the date you departed to the UK was before the arrival date then please select
In the majority of cases the date would be the same unless the flight is long haul or a late flight before midnight
Flight Number, coach or vessel name*
If you have transited through any additional countries please enter in the box
Section 2 of 3 - Who is travelling
Traveller 1 Details
Traveller 1 Name*
First Last
Traveller 1 Date Of Birth*
DD slash MM slash YYYY
Traveller 1 Gender*
- Male
- Female
Traveller 1 Ethnicity*
Vaccination Status*
Traveller 1 Passport Number*
Traveller 2 Details
Traveller 2 Name*
First Last
Traveller 2 Date Of Birth*
DD slash MM slash YYYY
Traveller 2 Gender*
- Male
- Female
Traveller 2 Ethnicity*
Vaccination Status*
Traveller 2 Passport Number*
Traveller 3 Details
Traveller 3 Name*
First Last
Traveller 3 Date Of Birth*
DD slash MM slash YYYY
Traveller 3 Gender*
- Male
- Female
Traveller 3 Ethnicity*
Vaccination Status*
Traveller 3 Passport Number*
Traveller 4 Details
Traveller 4 Name*
First Last
Traveller 4 Date Of Birth*
DD slash MM slash YYYY
Traveller 4 Gender*
- Male
- Female
Traveller 4 Ethnicity*
Vaccination Status*
Traveller 4 Passport Number*
Traveller 5 Details
Traveller 5 Name*
First Last
Traveller 5 Date Of Birth*
DD slash MM slash YYYY
Traveller 5 Gender*
- Male
- Female
Traveller 5 Ethnicity*
Vaccination Status*
Traveller 5 Passport Number*
Traveller 6 Details
Traveller 6 Name*
First Last
Traveller 6 Date Of Birth*
DD slash MM slash YYYY
Traveller 6 Gender*
- Male
- Female
Traveller 6 Ethnicity*
Vaccination Status*
Traveller 6 Passport Number*
Traveller 7 Details
Traveller 7 Name*
First Last
Traveller 7 Date Of Birth*
DD slash MM slash YYYY
Traveller 7 Gender*
- Male
- Female
Traveller 7 Ethnicity*
Vaccination Status*
Traveller 7 Passport Number*
Traveller 8 Details
Traveller 8 Name*
First Last
Traveller 8 Date Of Birth*
DD slash MM slash YYYY
Traveller 8 Gender*
- Male
- Female
Traveller 8 Ethnicity*
Vaccination Status*
Traveller 8 Passport Number*
Traveller 9 Details
Traveller 9 Name*
First Last
Traveller 9 Date Of Birth*
DD slash MM slash YYYY
Traveller 9 Gender*
- Male
- Female
Traveller 9 Ethnicity*
Vaccination Status*
Traveller 9 Passport Number*
Traveller 10 Details
Traveller 10 Name*
First Last
Traveller 10 Date Of Birth*
DD slash MM slash YYYY
Traveller 10 Gender*
- Male
- Female
Traveller 10 Ethnicity*
Vaccination Status*
Traveller 10 Passport Number*
Section 3 of 3 - Your Details
Contact Name*
First Last
Contact Number*
Email Address*
Delivery Address*
Address 1 Address 2 Town Postal Code Country
Consent to being tested
- 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 and hereby agree and consent for ROSHNI CLINIC to record and process your data in accordance with our Privacy Policy.
Due to government guidelines once your reference number has been generated we are unfortunately unable to process any refunds. Please ensure you require this booking prior to booking.

Total Cost
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Pay
Credit Card
Card Details
Cardholder Name
Please click on submit button to do payment

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Call Us: 0333 050 7138

Day 2/8 PCR Test Order Form

Please select how many people will be returning to the UK and require testing

Order Day 2 and 8 COVID 19 PCR TESTS - £ 195.00(includes x2 tests)

Section 1 of 3 - Your Travel Details

Section 2 of 3 - Who is travelling

Section 3 of 3 - Your Details