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(Please select no and complete the following section if you have not provided this information for the individual named above when booking your test)


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Additional Information Required for the UK Health Security Agency - please complete as fully as possible
(Mandatory for F2F certificates)

  • I consent to Cellmark carrying out a COVID-19 test on the donor’s sample (if the donor is a child I confirm that I have the legal authority to give consent).
  • I consent to the donor’s personal details being stored and processed by Cellmark (please see Cellmark’s privacy policy for data retention timeframes).
  • I consent to the donor’s test result and personal details being reported to the UK Health Security Agency, in compliance with public health legislation.
  • In the event of a positive result I understand my sample may be passed to Cellmark's sequencing partner for further analysis as detailed in the testing Terms and Conditions

Mandatory field