Covid-19 Screening

Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Please accept the terms
Invalid Input
Invalid Input
Captcha
Invalid Input
The completed form will be emailed to your chosen email address. Kindly print the form at home, sign and bring it along to the consultation visit. PLEASE NOTE: If you have answered YES to any of the questions, please contact the rooms PRIOR to your appointment for confirmation of any further measures that need to be taken which may or may not require having a Covid-19 lab test performed.
×

TOP

logo 03

Tel: 031-5368006
Address: 
Suite 309, Medstone Medical Centre,
19 High Street, off Umhlanga Ridge Boulevard,
Umhlanga

logo 03

Tel: 032-004 0055
Address: Ribumed Medical Centre

 (Behind Odyssey Mall)

1 Simbthi Drive
Ballito

Durban/Umhlanga 031-536 8006 / Ballito 032-004 0055 / This email address is being protected from spambots. You need JavaScript enabled to view it.