Request for Covid-19 Test
English
Ελληνικά
If you want to submit another request please click
here
.
Please complete and submit the form below and please note the following:
• If you will pay for your test, you will be directed to JCC for payment.
• If your employer will pay for your test, you will be asked to submit the code your employer gave you. (If you are an employer, and you want to arrange tests for your employees, please call us at 22476777).
Personal Information
Please enter your name in capital Latin characters as it written in your ID
Last Name:
*
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First Name:
*
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Date of Birth:
*
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Type of ID:
*
Cyprus ID / Κυπριακή Ταυτότητα
Passport / Διαβατήριο
Other ID / Άλλη Ταυτότητα
ARC / ARC
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Gender:
*
Female / Γυναίκα
Male / Άνδρας
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ID Number:
*
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Address:
*
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Town/City and Postal Code:
*
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District:
*
AMMOCHOSTOS / ΑΜΜΟΧΩΣΤΟΣ
LARNACA / ΛΑΡΝΑΚΑ
LEMESOS / ΛΕΜΕΣΟΣ
LEFKOSIA / ΛΕΥΚΩΣΙΑ
PAFOS / ΠΑΦΟΣ
BRITISH BASES / ΒΡΕΤΑΝΙΚΕΣ ΒΑΣΕΙΣ
ABROAD / ΕΞΩΤΕΡΙΚΟ
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Mobile Number:
*
AUS (+61)
AUT (+43)
BEL (+32)
BGR (+359)
CHE (+41)
CYP (+357)
DEU (+49)
DNK (+45)
EGY (+20)
EST (+372)
FIN (+358)
FRA (+33)
GBR (+44)
GEO (+995)
GRC (+30)
HUN (+36)
IRL (+353)
ISL (+354)
ISR (+972)
ITA (+39)
LTU (+370)
LVA (+371)
NLD (+31)
NOR (+47)
NZL (+64)
POL (+48)
ROU (+40)
SVK (+421)
SVN (+386)
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We will use your mobile number to:
(1) send you SMS messages to inform you of the status of your request,
(2) send you an SMS message to inform you if your test result is negative,
(3) call you if your test result is positive.
Email Address (optional):
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If you provide your email address, we will send you your test result by email as well.
Contact Person in Case of Emergency
Last Name:
*
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First Name:
*
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Relation:
*
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Mobile Number:
*
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Test & Payment
Regular Processing Time – RT PCR Test
• RT PCR: Molecular test to detect the presence of COVID 19 Virus in nasopharyngeal swab.
• Test turnaround time: 6 to 24 hours after specimen collection (*).
• Cost: 25 Euro (non-refundable).
(*) If the sample is taken at AMC Limassol after 10:00 am, the results will be available within 36 hours.
Rapid Antigen COVID-19 Test
• Detection of COVID-19 Antigen in nasopharyngeal swab.
• Test turnaround time: 45 minutes after specimen collection.
• Cost: 5 Euro (non-refundable).
Payment:
*
Private / Ιδιώτης
Paid by my Employer / Κάλυψη εξόδων από τον εργοδότη μου
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Code:
*
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Employer:
Preferred Location for Sample Taking:
*
AMC Nicosia (Casualty Area) / AMC Λευκωσία (Χώρος Πρώτων Βοηθειών)
AMC Limassol / AMC Λεμεσός
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Test:
*
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Agreed Location for Sample Taking:
Agreed Date αnd Time:
Agreed Test Type:
Schedule Date:
*
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November 2024
Sun
Mon
Tue
Wed
Thu
Fri
Sat
44
27
28
29
30
31
1
2
45
3
4
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6
7
8
9
46
10
11
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13
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47
17
18
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20
21
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23
48
24
25
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30
49
1
2
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7
Clear
Jan
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OK
Cancel
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Schedule Time:
*
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If your test is sponsored by the Ministry of Health, please attach below a document confirming your eligibility for the test.
Government Sponsored Eligibility Document
*
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In addition, please print this
form
, complete it and attach it below.
Government Sponsored Document
*
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Please note that if you do not attach the correct documents, we will have to reject your request.
The American Medical Center follows the General Data Protection Regulation (GDPR), therefore the personal data we collect about you is solely processed for performing the requested COVID 19 test. We will not share your personal data with any third party unless the outcome of the test is positive or in case the test is performed by AMC on behalf of the Ministry of Health, in which cases your results will be shared with the Ministry as required by law. All personal data, including your test results, will be erased from our systems as per our legal obligations. In case you need more information regarding the protection of your personal data including the exercise of your subject rights please view our privacy policy at
https://amc.com.cy/
or by emailing our Data Protection Officer at
[email protected]
. For further information on the GDPR or if you wish to lodge a complaint to the Office of the Commissioner for the Protection of Personal Data please visit
https://www.dataprotection.gov.cy
.
Submit
Please complete all the mandatory fields / Παρακαλώ συμπληρώστε όλα τα υποχρεωτικα πεδία