COVID-19 Testing Enrolment
Enroll for testing
1. Title*
Mr
Mrs
Ms
Miss
2. First Name*
3. Last Name*
4. Gender*
Male
Female
5. Date of Birth*
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
Year
6. Passport Number*
7. SA ID Number
8. International Dialling Code*
South Africa: +27
Afghanistan: +93
Aland Islands: +358
Albania: +355
Algeria: +213
AmericanSamoa: +1684
Andorra: +376
Angola: +244
Anguilla: +1264
Antarctica: +672
Antigua and Barbuda: +1268
Argentina: +54
Armenia: +374
Aruba: +297
Ascension Island: +247
Australia: +61
Austria: +43
Azerbaijan: +994
Bahamas: +1242
Bahrain: +973
Bangladesh: +880
Barbados: +1246
Belarus: +375
Belgium: +32
Belize: +501
Benin: +229
Bermuda: +1441
Bhutan: +975
Bolivia: +591
Bosnia and Herzegovina: +387
Botswana: +267
Brazil: +55
British Indian Ocean Territory: +246
Brunei Darussalam: +673
Bulgaria: +359
Burkina Faso: +226
Burundi: +257
Cambodia: +855
Cameroon: +237
Canada: +1
Cape Verde: +238
Cayman Islands: +1345
Central African Republic: +236
Chad: +235
Chile: +56
China: +86
Christmas Island: +61
Cocos (Keeling) Islands: +61
Colombia: +57
Comoros: +269
Congo: +242
Cook Islands: +682
Costa Rica: +506
Croatia: +385
Cuba: +53
Cyprus: +357
Czech Republic: +420
Democratic Republic of the Congo: +243
Denmark: +45
Djibouti: +253
Dominica: +1767
Dominican Republic: +1849
Ecuador: +593
Egypt: +20
El Salvador: +503
Equatorial Guinea: +240
Eritrea: +291
Estonia: +372
Eswatini: +268
Ethiopia: +251
Falkland Islands (Malvinas): +500
Faroe Islands: +298
Fiji: +679
Finland: +358
France: +33
French Guiana: +594
French Polynesia: +689
Gabon: +241
Gambia: +220
Georgia: +995
Germany: +49
Ghana: +233
Gibraltar: +350
Greece: +30
Greenland: +299
Grenada: +1473
Guadeloupe: +590
Guam: +1671
Guatemala: +502
Guernsey: +44
Guinea: +224
Guinea-Bissau: +245
Guyana: +592
Haiti: +509
Holy See (Vatican City State): +379
Honduras: +504
Hong Kong: +852
Hungary: +36
Iceland: +354
India: +91
Indonesia: +62
Iran: +98
Iraq: +964
Ireland: +353
Isle of Man: +44
Israel: +972
Italy: +39
Ivory Coast / Cote d'Ivoire: +225
Jamaica: +1876
Japan: +81
Jersey: +44
Jordan: +962
Kazakhstan: +77
Kenya: +254
Kiribati: +686
Korea, Democratic People's Republic of Korea: +850
Korea, Republic of South Korea: +82
Kosovo: +383
Kuwait: +965
Kyrgyzstan: +996
Laos: +856
Latvia: +371
Lebanon: +961
Lesotho: +266
Liberia: +231
Libya: +218
Liechtenstein: +423
Lithuania: +370
Luxembourg: +352
Macau: +853
Madagascar: +261
Malawi: +265
Malaysia: +60
Maldives: +960
Mali: +223
Malta: +356
Marshall Islands: +692
Martinique: +596
Mauritania: +222
Mauritius: +230
Mayotte: +262
Mexico: +52
Micronesia, Federated States of Micronesia: +691
Moldova: +373
Monaco: +377
Mongolia: +976
Montenegro: +382
Montserrat: +1664
Morocco: +212
Mozambique: +258
Myanmar: +95
Namibia: +264
Nauru: +674
Nepal: +977
Netherlands: +31
Netherlands Antilles: +599
New Caledonia: +687
New Zealand: +64
Nicaragua: +505
Niger: +227
Nigeria: +234
Niue: +683
Norfolk Island: +672
North Macedonia: +389
Northern Mariana Islands: +1670
Norway: +47
Oman: +968
Pakistan: +92
Palau: +680
Palestine: +970
Panama: +507
Papua New Guinea: +675
Paraguay: +595
Peru: +51
Philippines: +63
Pitcairn: +872
Poland: +48
Portugal: +351
Puerto Rico: +1939
Qatar: +974
Reunion: +262
Romania: +40
Russia: +7
Rwanda: +250
Saint Barthelemy: +590
Saint Helena, Ascension and Tristan Da Cunha: +290
Saint Kitts and Nevis: +1869
Saint Lucia: +1758
Saint Martin: +590
Saint Pierre and Miquelon: +508
Saint Vincent and the Grenadines: +1784
Samoa: +685
San Marino: +378
Sao Tome and Principe: +239
Saudi Arabia: +966
Senegal: +221
Serbia: +381
Seychelles: +248
Sierra Leone: +232
Singapore: +65
Sint Maarten: +1721
Slovakia: +421
Slovenia: +386
Solomon Islands: +677
Somalia: +252
South Georgia and the South Sandwich Islands: +500
South Sudan: +211
Spain: +34
Sri Lanka: +94
Sudan: +249
Suriname: +597
Svalbard and Jan Mayen: +47
Sweden: +46
Switzerland: +41
Syrian Arab Republic: +963
Taiwan: +886
Tajikistan: +992
Tanzania, United Republic of Tanzania: +255
Thailand: +66
Timor-Leste: +670
Togo: +228
Tokelau: +690
Tonga: +676
Trinidad and Tobago: +1868
Tunisia: +216
Turkey: +90
Turkmenistan: +993
Turks and Caicos Islands: +1649
Tuvalu: +688
Uganda: +256
Ukraine: +380
United Arab Emirates: +971
United Kingdom: +44
United States: +1
Uruguay: +598
Uzbekistan: +998
Vanuatu: +678
Venezuela, Bolivarian Republic of Venezuela: +58
Vietnam: +84
Virgin Islands, British: +1284
Virgin Islands, U.S.: +1340
Wallis and Futuna: +681
Yemen: +967
Zambia: +260
Zimbabwe: +263
9. Phone Number*
10. Email Address*
11. Secondary Email Address*
12. Permanent Address*
13. Resident Province*
14. Resident Country*
South Africa
Afghanistan
Aland Islands
Albania
Algeria
AmericanSamoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast / Cote d'Ivoire
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of Korea
Korea, Republic of South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan Da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela, Bolivarian Republic of Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Yemen
Zambia
Zimbabwe
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