Doctors Hospital (Bahamas) COVID-19 RT-PCR Test Booking Form

Doctors Hospital (Bahamas) COVID-19 RT-PCR Test Booking 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?*

IndividualCorporate Group
Doctors Hospital provides Corporate Group COVID-19 Testing. To schedule testing for your Corporate Group, please click here.

I. Select Test Location

Select the Island and Location at which you wish to be tested.
Select the type of test(s) you wish to create an appointment for:*

COVID-19 PCR TestingCOVID-19 PCR Testing + RAPID ANTIGEN TESTING
To book for Rapid Antigen Testing Only, please click here.
Island*

New ProvidenceGrand Bahama
Choose a Test Collection Site*

Doctors Hospital Carmichael (next to Bahamas Christian Fellowship Center)Meldon Mall (Mackey Street, across from Commonwealth Bank)
Choose a Test Collection Site*

First Commercial Center
Choose a Test Collection Site (results in 36-48 hours)*

Doctors Hospital Exuma

II. Demographic Information

Please complete the required demographic information as per The Bahamas Ministry of Health Guidelines.
IMPORTANT! Please enter your information as is written on your government-issued identification.
Name*

First NameLast Name
Gender*

MaleFemale
Date of Birth*

DayMonthYear
DD/MM/YYYY
Age*
Legal ID Type:*
Legal ID Number*
NIB Number
Price
Age*
Senior Discount
Email Address*

Confirmation EmailIMPORTANT! Necessary information on payment and accessing your appointment will be sent to you via email. Please provide an email address that you will have access to for further guidance.
Primary Telephone Contact*
Secondary Telephone Contact
Residential Address*

Street Address (including House Number)

Street Address Line 2

City/SettlementIsland / State / Providence

P.O. Box / Zip CodeCountry
Island of Residence in the Last 14 days*
Employment Status*

Full-time EmployedPart-time EmployedSelf-employedUnemployed
Name of Employer*
NOTE: We will not contact your employer regarding your COVID-19 test results.
Employer Phone Contact*
NOTE: We will not contact your employer regarding your COVID-19 test results.
Next of Kin*
First and Surname Required
Relationship*
Next of Kin Telephone Contact*

III. Select Appointment

Select Your Appointment Time
Is your test for DOMESTIC travel (i.e. within The Bahamas)?

YesNo
Please upload a copy of your boarding pass, itinerary or travel confirmation.

Cancelof
Select an Appointment
Upload photo of physician referral letter or requisition (OPTIONAL)

Cancelof
Priority of Results

Within 24 hoursLess than 3 days3-5 days5+ days
Test Price: ${price} (VAT included)

You will receive an online link via email to pay for your test upon submission of this form.
Select an Appointment
Select an Appointment
Select An Appointment (Town Center Mall)
Select An Appointment (British Colonial Hilton)
Select An Appointment (Carmichael Road)
Select An Appointment (Meldon Mall, Mackey Street (across from Commonwealth Bank)
Select An Appointment (Prince Charles Drive, next to Super Value Winton)
Select An Appointment (First Commercial Center)
Select An Appointment (Doctors Hospital Exuma)

V. 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

DayMonthYear
Date
Signature*

Clear
Should be Empty:

I. Select Test Location