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COVID ANALYSIS REQUEST FORM

Please complete the following form to help us understand your physical condition.

INFO.png
TEST
VACCINE
VOYAGE#
SYMPTOMATIQUE
RAPPORT en anglais
ATTESTATION VOYAGE

TRAVEL# : PCR - Without medical prescription, on-site sampling paid for by the patient. CASH payment CHF 100;Antigen test  rapid 50 CHF
NOTE: Holidays and weekends PRICE 150 CHF

Thank you for what you sent !

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