Book a COVID-19 Test - Medelit United Kingdom

Notice - Tests are sent to our partnered labs by mail and each test has specific processing times. We can normally provide results for both PCR swabs and antibody tests within 24-48 hours, but may experience delays that are not directly dependent on us (example increased lab workload or disruption of mail services). As soon as we receive the test results from the lab, we will send these over to you and give you a call to inform you that your results are ready.
I have already received full information on COVID 19 Test FEES and timing and want to proceed with the Booking*
- Yes
- No
This is a Booking form. If you require information before deciding whether to book a service with us, please chat with us on the website or contact us through our enquiry form before booking.
I am a*
- Returning Patient
- New to Medelit
The test I am asking is for*
If you are requesting the COVID19 test for more than one person, please take notice you will need all their information to complete this form.
- For myself Only
- For more than 1 person (same address)
Your Name and Surname*
Name (and any second name) Surname
Email*
Phone 1*
We highly recommend that you leave us 2 phone numbers.
Mobile / Telephone 2

ADDRESS WHERE YOU NEED US TO CARRY OUR THE SWAB
Address*
Street Address City ZIP / Postal Code Country

BILLING ADDRESS INFORMATION
Is the Home Visit Address the same as Your Billing Address?*
- Yes
- No
Billing Address*
Street Address Address Line 2 City ZIP / Postal Code Country
Date of Birth*
DD slash MM slash YYYY

Type of COVID 19 Test*
- PCR Swab
- Rapid Antigen COVID-19 Swab
- COVID-19 Antibody Test (Blood sample)
Do you wish to add a Video-Consultation with one of our Doctors to discuss your Test Results?*
- Yes, I wish to add a video-consultation with a Medelit Doctor
- No, I will talk to my GP
The additional fee for this service is of 87 £.
Preferred Date and/or Time for the Nurse Appointment

We will do our best to accommodate your request.

We're nearly done! Now to CONSENT AND PRIVACY
Are you filling this form for yourself?
- Yes
- No
Do you have consent to book this visit and share the patient's information with us?*
- Yes
- No, but I have Power of Attorney
Please take notice that if you are NOT the person we are visiting and you do not have their consent, you can provide consent ONLY if you have Power of Attorney. The Power of Attorney Documentation will need to be uploaded within this form.
Your Name*
First Last
Please place the name of the person completing this form.
Have you been Appointed Power of Attorney?*
- Yes
- No
Please take notice this is for Health and Welfare as well as for property and financial affairs. Please take notice that if the person we are visiting is NOT a child under the age of 18 for whom you have parental responsibility, you can only provide consent if you have been appointed Power of Attorney. If your answer is NO, this means you do not ahave a right to give consent. Please take notice that we cannot process your booking without the patient's consent to the treatment of their data.
Please confirm that you have Power of Attorney Documentation to Provide and that you have understood this must be sent separately by email to us.*
- YES, I will send Power of Attorney Documentation by Email
The Consent Form will not be complete until we have received Power of Attorney Documentation by Email.
Signature
Consent*
Acceptance of terms
By selecting you are confirming that you have read and accepted our booking terms & conditions and that you are providing consent to the visit and our privacy policy in regards to treatment of your data.
The privacy policy can be accessed through this link: https://www.medelit.com/uk/data-protection-policy/
Phone
This field is for validation purposes and should be left unchanged.

COVID 19 Test BOOKING

Step 1 of 8

This is a Booking form. If you require information before deciding whether to book a service with us, please chat with us on the website or contact us through our enquiry form before booking.

ADDRESS WHERE YOU NEED US TO CARRY OUR THE SWAB

BILLING ADDRESS INFORMATION

SHORT TRIAGE

SECOND PERSON INFORMATION

THIRD PERSON

We're nearly done! Now to CONSENT AND PRIVACY

COVID 19 Test BOOKING

Step 1 of 8

This is a Booking form. If you require information before deciding whether to book a service with us, please chat with us on the website or contact us through our enquiry form before booking.

ADDRESS WHERE YOU NEED US TO CARRY OUR THE SWAB

BILLING ADDRESS INFORMATION

SHORT TRIAGE

SECOND PERSON INFORMATION

THIRD PERSON

We're nearly done! Now to CONSENT AND PRIVACY

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