Proctoring Test Form

We need to contact information of the primary traveler so we can send the necessary invitation links and result certificates.
We need to verify that your Name, Birthdate and Gender match the information in your Passport a) Every Adult (18 Year or Older) should establish their own profile.
We need to know how many people will be proctored in the same session, so we can allocate enough time to getting you tested and traveling.
If you did not purchase a Test Kit from us prior to completing this form, but you have your own Test Kits, we will need to charge you for the Proctoring Session.

TRAVELER NAME ( if a family/group you can just list main traveler) (Required)

First Name

Last Name

MOBILE PHONE (Required)

HOME PHONE

EMAIL ADDRESS YOUR REGISTERED WITH (Required)

NUMBER OF PEOPLE

LOCATION ( i.e. Paris or Cancun) This helps with time zone issues

PROCTORING DATE It Should be within 24 hours of departure

PROCTORING TIME : If you want 9 am in Paris. Put 9 am.