Book Test Now - Dua Clinic

COVID-19 Testing & Telehealth Appointments

To book your testing or telehealth appointment, please complete the form below. Call 030 222 7678 or 030 222 3666 for any further assistance.

Please complete this form before your appointment. Read the instructions carefully and complete all fields.

Your Full Name(Required)

First Middle Last

Your Email Address(Required)

Your Phone Number(Required)

Please enter your WhatsApp number (if different from phone number)

Your Gender

Female

Male

Your Date of Birth(Required)

Your Nationality(Required)

Your Residential Address(Required)

Closest Landmark to Residential Address

Service Required(Required)

Test Location(Required)

Purpose for Testing(Required)

Passport Number

How would you like your results sent?(Required)

Both

Reason for Appointment (Symptoms)(Required)

Appointment Date & Time(Required)

Please select location.

Total

Payment Method