COVID19 Pre-flight LFD Test | Belgravia Guardians

This form is for the pre-flight LFD/RAT test.

Please book the test before 11am (British time) Monday-Friday for same day dispatch. Please contact us first for any last-minute booking.

Please also ensure you have filled out the information as accurately as possible. We will not be responsible for any inaccurate information.

Last Name/ Surname (As shown in your passport)

First Names/ Given Names (As shown in your passport)

Date of Birth

Passport Number

Sex

Ethnicity

NHS number (if known and applicable)

Vaccination status

Vaccination type

First dose date (Leave blank if not received)

Second dose date (Leave blank if not received)

Parents contact phone number

Name of UK contact (Houseparent or matron, if applicable)

Postal address of the test kit (line 1)

Postal address line 2

Postal address line 3

Town, county

Postcode

Flight Departure Date

Departure time

Train/Flight Number

Additional information

I 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.

I accept terms & conditionsView

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