Замовлення - МедЛаб

Information about your self*

Last name First name Surname

Do you need the test result in English*

Enter the last and first name as in the passport

First name Last name

Passport data

Series Number

Gender*

Birth date*

Phone number*

Email*

* To removed from self-isolation, specify the number to which the Home Action application is linked

Address of residence in Ukrainian*

The address is required in accordance with regulatory regulations.

Have you been in SARS-COV-19 local transmission of the virus?*

Choose a country

Have the person been in contact with a laboratory-confirmed diagnosis SARS-COV-19*

covid19

Choose a test*

Additional fee

The cost of biomaterial collection is additionally paid for the PCR test at UAH 50

Additional fee

Consent to the processing of personal data*

Total

0.00 ₴

Order form for passing the COVID-19 test