You are being asked to give consent to Nutraceuticals Laboratory London (NLL) for collection of samples from your throat and nose for testing for the antigen which comprises SARS-COVID-2, virus which causes the disease Covid-19.
Your sample will not be tested for evidence of any other disorder. The sample will be sent to a central laboratory for analysis. These Laboratories are approved by UKHSA. The test is approved by UKAS. A copy of the result will be emailed to you.
Your privacy will be protected in compliance with General Data Protection regulation
Information Required for Test and Trace
However, if your result is positive as with all notifiable diseases, Covid-19 test results must be shared with Public Health services. Positive Covid test information is vital for Test and Trace to follow up in the community. Your contact details (Full name; address; telephone number; GPs contact details, will be supplied to Public Health Services). There are no valid exemptions or GDPR restrictions for this notifiable disease.
IF YOU CHOOSE TO VISIT OUR CLINIC FOR SELF SAMPLE TAKING, PLEASE WEAR A FACE MASK AS SOON AS YOU ENTER OUR PREMISES AND AT ALL TIMES DURING YOUR VISIT.
I confirm that I have no symptoms for COVID-19.
I give NLL permission to share my results and contact details with any Public Health Service or to do so on my behalf.
NAME OF PATIENT: As stated on contact form which is completed on Nutraceuticals Laboratory London Limited website.
Signature of Patient: Date: Time: - By completion and acceptance of contact form on Nutraceuticals Laboratory London Limited website.
By clicking this form, you are deemed to have given your consent for testing.
Nutraceuticals Laboratory London Limited,
2nd floor, 151-153 Uxbridge Road, Ealing, London W13 9AU, United Kingdom