Covid staff testing request

Please select the option that best describes you. *

First name(s) *

Last name *

Date of birth *//

Job role *

Work location *

Please share details of where you are based during working e.g. Ward L4

Email

Email *

Consent for clinical email *

I consent to recieve emails

Consent for clinical email allows us to send information to a non NHS email address.

Home address

Property name / number *

Please enter details for your place of residence.

Street name *

Town / City *

Postcode *

Phone number *

Email *

Your appointment details will be emailed to the address you provide - please provide one you can access from home.

For CUH staff ONLY

If the person needing testing is a child, please provide the following to act as a proxy for them.

Name of parent/guardian/carer

Phone number

Relationship to symptomatic person

e.g. parent

Symptoms

Please select at least one of the symptoms you are experiencing. *

I have a high temperature - this means a feeling of feverishness, or a measured temperature >37.8oC.
I have a new cough - this means a new intermittent or persistent cough, or worsening of your usual cough (if you have one).
I have a loss or change in my sense of taste or smell.
I have minor symptom(s) (these include (a) a sore throat; (b) nasal discharge or congestion; (c) muscle aches; (d) new hoarseness; (e) new shortness of breath; (f) a new wheeze).

Please provide the date for when you first experienced symptoms, or had a positive lateral flow test. *//

Please self-isolate until you have your test result.

Where to get tested

Symptomatic testing is available either at the S2 Pods at CUH (link to map), or the Pod outside the Dyson Building, Department of Engineering, Fen Causeway (link to map)

Please select a preferred location *

S2 Pod CUH
Fen Causeway Pod, outside the Baker Building

Results

All results are automatically available via MyChart, so we strongly advise registering now. This is the fastest way to receive results. If you do not consent to receiving your results via MyChart, they will be communicated to the email address you provide above, however this method is likely to be substantially slower.

For more details, please see our MyChart website pages.

Receiving your results through MyChart *

Yes, I opt in to receiving my results via MyChart on Epic.
No, I do not opt in to MyChart and realise emailed results are likely to arrive substantially more slowly

You will be assigned the next available appointment, details of which will be emailed to the address you provide within 24 hours, generally considerably quicker. Please look out for this email.