Accu Diagnostics Antigen Test Registration Form (Office)

Welcome to the Accu Diagnostics Antigen Registration Form! Please fill out this form with your correct details.

Remember to enter the ID number of the ID type you chose, and to upload a photo of it to our portal. (E.g. Passport Number if you’re using a Passport, or Driver’s License Number if you’re using your Driver’s license.

Your workplace is the company your work for.

Accu Diagnostics Antigen Registration Form (Office)

"*" indicates required fields

Unique ID

Hidden

Order ID

Date*

Time*

Name*

First Middle Last

Date of Birth*

Sex*

Male

Female

Nationality*

ID Type*

Passport

Driver's licence

National ID

NHIP

ID Number*

Please upload a copy of your ID.*

Max. file size: 2 GB.

Email*

Enter Email Confirm Email

Phone*

Address on Island.*

Street Address City Country

Workplace/School*

Occupation*

Symptoms being experienced?*

Reason for Testing?*

Hidden

Test Results