[email protected]
ARRIVE ALIVE DIAGNOSTICS AND IMAGING SERVICES
Home
My Covid Bookings
PHA
COVID-19 TEST BOOKING
Registration Information
Personal Information
Full Name
*
Phone Number
*
Email Address
*
Date of Birth
*
Sex
*
Please Select
Male
Female
Nationality
Please select Country
State of Residence
Select State
Local Government Area
*
Please Select
Residential Add.
*
Occupation
Covid-19 Information
Have you had close contact with sick person(s) (persons with fever, cough and difficulty in breathing) in the past 14 days ?
Yes
No
Have you tested Positive for Covid-19 Before?
Please select
Yes
No
Date Tested Positive
Proceed