Doctors Hospital (Bahamas) COVID-19 Test Request Form

Doctors Hospital (Bahamas) COVID-19 Test Request Form

For the health and safety of our community, Doctors Hospital (Bahamas) Ltd. provides RT-PCR COVID-19 Test Services. Be sure that the information you'll give is accurate and complete. Please contact your Physician if you have any symptoms associated with COVID-19.
Are you interested in testing for yourself/an individual or a Corporate Group? *

Individual Corporate Group
IMPORTANT NOTES ABOUT GROUP TESTING:

Thank you for choosing Doctors Hospital Group testing services. Kindly note the following below:
- Please only complete one (1) group test request form per company/department. Once submitted, you will be contacted automatically via email with the next steps for organizing testing for your group. Shortly thereafter, you will be contacted by a Member of our team to continue to walk you through the process.
- Group testing services are available for companies/organizations/corporate groups. If you are interested in testing for members of your family, do NOT select Corporate Group. Instead, please select "Individual" and complete one form per individual/family member.
Have you had a positive COVID-19 PCR Test or diagnosis in the last 14 days?

Yes No
As you have had a positive COVID-19 PCR test in the past 14 days, you are required to isolate. It is advised that you re-test only after 14 days have passed from your initial positive COVID-19 PCR Test.

DECLARATIONS & DISCLAIMERS
I agree to my test results being sent to the email address I have provided above *

I agree
I acknowledge that I completed this form myself, and that the information I have provided in this form is accurate and complete, including all contact and address information.

I agree
I understand that should my results come back positive, Doctors Hospital is obligated to alert The Bahamas Ministry of Health officials.

I agree
I understand that following the submission of this form, I will be sent via email a link to pay my charges online. I understand that online payment is mandatory prior to my visit (payment will not be collected on site, and cash payments will not be accepted).

I agree
I understand that specimens can take 24-36 hrs to process, and that results can be delayed for reasons including (but not limited to) the need for a specimen to be re-processed, incomplete or accurate information provided by the patient, public health notification requirements, etc. Should delays occur, Doctors Hospital is not responsible for any travel-related delays or cancellations as a result.

I agree
Date

Day Month Year
Date
Signature *

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REQUESTER INFORMATION