COVID-19 Activation Form

Please complete the activation form for each individual test.

Once you’ve completed this form please label your sample by following the provided user guide and send it to our laboratory for testing using the prepaid mailing bag, following the provided instruction guide.

Once your sample has been received by our expert health team you will be sent an email to view your results typically within 24 hours.

1. Personal details of sample
Title*
Sex*
First Name*
Last Name*
Date of Birth*
YYYY slash MM slash DD
2. Where do you want your results sending?
Email address*
Email address Confirm email address
3. Order details
Unique Reference Code*
4. Consent

You agree to providing us with the requested personal information. This information will be used for reporting positive test results to PHE only. We will hold this information for a period of one month in case the PHE need further information, after this time it will be deleted. If further clarification is required after this period we may need to request the information from you again.
Privacy Policy*
I consent to processing of my data according to Check My Body Health's Privacy Policy
Terms and Conditions*
I confirm I have read and agree to your terms and conditions
Testing*
I give Check My Body Health and it's chosen Laboratory Partners permission to test my sample
Research & Development
I consent to my sample being used for Research & Development purposes
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COVID-19 Activation Form

1. Personal details of sample

2. Where do you want your results sending?

3. Order details

4. Consent