Antigen Testing

Name - As it appears on our passport *

Date of Birth *

Passport Number *

Date of Travel *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gender *

Male
Female
Unknown

Email *

Mobile - Irish mobile number only *

Do you require a travel cert with a QR code?

Yes
No

Checkboxes *

I confirm I have no symptoms
I confirm all the above details are correct & match my passport.
I understand these details cannot be changed once submitted

I understand Tramore Medical Clinic are providing me with a certified professional antigen test and do not offer guidance with regard to use for travel. I will establish any requirements regarding test type and valid use dates myself. You will receive your results 15 minutes after the appointment. A travel cert with a QR code can also be provided.

Date *

Signature *

OUR PRACTITIONERS

TRAMORE MEDICAL CLINIC

OPENING HOURS

Antigen Testing

OUR PRACTITIONERS

TRAMORE MEDICAL CLINIC

OPENING HOURS

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