Complete Registration Form

Breathe Assured submits all the information captured on the Registration Form directly to Public Health England in line with government travel regulations. 

Please note:
  • This form is only required for Rapid Antigen tests.
  • Please complete a separate form for each person attending the test supervision.
  • Please complete this form PRIOR to attending your appointment as it will be used to generate your certificate.
  • It is important to ensure all details are captured correctly. The nurse will have limited access to make changes to the form during your appointment.
  • A separate registration form is required for your outbound and inbound journey especially where a Rapid Antigen test is required for both trips.

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