Registration

Location/Event: *

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SARS-CoV-2 Test: *

Rapid Test - Result in 15 min / PCR Test - Result between 24 and 30 hours

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Date: *

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Testing Times: *

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First name: * As on your ID for Certificate

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Surname: * As on your ID for Certificate

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Birthdate: *

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Gender: *

Female

Male

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Telephone: *

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Email Address: *

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SWISS COVID App Transfer Code (optional):

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Passport Number (optional):

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Home Address

Country: *

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Street Address: *

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Postal Code: *

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Town: *

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I have a Swiss Health Insurance Number

If you don't have a health insurance number you will be charged for the test.

Health Insurance Number: *

80756

Health insurance number invalid.

Please carefully check that all the details are correct. Thank you.

Location/Event:

Testing:

Name:

Birthdate:

Gender:

Telephone:

Email:

Passport:

SWISS COVID App:

Address:

Health Insurance Number:

I agree to pay for the Test

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I confirm that all details are correct and agree to the terms & conditions

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I confirm that I am healthy
(if you are ill, please call +41 (0)81 822 1200)

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