Test To Release Order Form

- Step 1 of 3

Which tests do you need? * Please choose from the dropdown listFit to Fly PCRPre departure rapid antigen (Lateral Flow) testPCR Healthcare ScreeningAntibodyFit to Fly - Witnessed PCRPre departure antigen - Witnessed

* Applicable for travel as of Sunday 9th January

Delivery OptionPostal DeliveryCollect in person

Postal Delivery - Royal Mail standard delivery
Collect in person - Collect direct from our Lab

When attending our laboratory please wear masks at all times, and please park on the road outside (as parking is extremely limited) .
20/30 Labs Ltd
Unit 6 Osyth Close
Brackmills Industrial Estate, Northampton
NN4 7DY

How many people do you need tests for? (Including you if you need a test)

Selected Value: 1

How many tests do you need per person?

Selected Value: 1

Next

Person 1

Full Name (Person 1) *

First

Last

Email *

Email

Confirm Email

Phone Number *

Sex *Please Select an OptionMaleFemale

Date of Birth *

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Ethnicity *Please Select an OptionAsian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhiteAnother ethnic groupPrefer not to say

Passport Number *

NHS Number (If Known)

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Will you be quarantining at a different address if/when returning to the UK? *Please Select an OptionYesNo

Quarantine Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Vaccination Status *Vaccinated (Full Program Complete)In Progress (Part Administered)Unvaccinated

Date of Departure from the UK *

Please select today’s date if this is not applicable.
Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date of expected return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date departing overseas territory for return to the UK *

This is the date you commence your return travel. Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Countries travelled through in last 14 days? *

Please enter each value separated by a comma e.g: Canada, Germany, Japan

Flight, vessel, train, bus, route number on return to the UK *

Person 2

Full Name (Person 2) *

First

Last

Email *

Email

Confirm Email

Phone Number *

Sex *Please Select an OptionMaleFemale

Ethnicity *Please Select an OptionAsian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhiteAnother ethnic groupPrefer not to say

Date of Birth *

DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Passport Number *

NHS Number (If Known)

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Will you be quarantining at a different address if/when returning to the UK? *Please Select an OptionYesNo

Quarantine Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Vaccination Status *Vaccinated (Full Program Complete)In Progress (Part Administered)Unvaccinated

Date of Departure from the UK *

Please select today’s date if this is not applicable.
Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date of expected return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date departing overseas territory for return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Countries travelled through in last 14 days? *

Please enter each value separated by a comma e.g: Canada, Germany, Japan

Flight, vessel, train, bus, route number on return to the UK *

Person 3

Full Name (Person 3) *

First

Last

Email *

Email

Confirm Email

Phone Number *

Sex *Please Select an OptionMaleFemale

Date of Birth *

DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Ethnicity *Please Select an OptionAsian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhiteAnother ethnic groupPrefer not to say

Passport Number *

NHS Number (If Known)

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Will you be quarantining at a different address if/when returning to the UK? *Please Select an OptionYesNo

Quarantine Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Vaccination Status *Vaccinated (Full Program Complete)In Progress (Part Administered)Unvaccinated

Date of Departure from the UK... *

Please select today’s date if this is not applicable.
Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date of expected return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date departing overseas territory for return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Countries travelled through in last 14 days? *

Please enter each value separated by a comma e.g: Canada, Germany, Japan

Flight, vessel, train, bus, route number on return to the UK *

Person 4

Full Name (Person 4) *

First

Last

Email *

Email

Confirm Email

Phone Number *

Sex *Please Select an OptionMaleFemale

Date of Birth *

DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Passport Number *

NHS Number (If Known)

Ethnicity *Please Select an OptionAsian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhiteAnother ethnic groupPrefer not to say

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Will you be quarantining at a different address if/when returning to the UK? *Please Select an OptionYesNo

Quarantine Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Vaccination Status *Vaccinated (Full Program Complete)In Progress (Part Administered)Unvaccinated

Date of Departure from UK *

Please select today’s date if this is not applicable.
Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date of expected return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date departing overseas territory for return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Countries travelled through in last 14 days? *

Please enter each value separated by a comma e.g: Canada, Germany, Japan

Flight, vessel, train, bus, route number on return to the UK *

Person 5

Full Name (Person 5) *

First

Last

Email *

Email

Confirm Email

Phone Number *

Sex *Please Select an OptionMaleFemale

Date of Birth *

DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Passport Number *

NHS Number (If Known)

Ethnicity *Please Select an OptionAsian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhiteAnother ethnic groupPrefer not to say

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Will you be quarantining at a different address if/when returning to the UK? *Please Select an OptionYesNo

Quarantine Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Vaccination Status *Vaccinated (Full Program Complete)In Progress (Part Administered)Unvaccinated

Date of Departure from the UK *

Please select today’s date if this is not applicable.
Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date of expected return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date departing overseas territory for return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Countries travelled through in last 14 days? *

Please enter each value separated by a comma e.g: Canada, Germany, Japan

Flight, vessel, train, bus, route number on return to the UK *

Person 6

Full Name (Person 6) *

First

Last

Email *

Email

Confirm Email

Phone Number *

Sex *Please Select an OptionMaleFemale

Date of Birth *

DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Passport Number *

NHS Number (If Known)

Ethnicity *Please Select an OptionAsian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhiteAnother ethnic groupPrefer not to say

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Will you be quarantining at a different address if/when returning to the UK? *Please Select an OptionYesNo

Quarantine Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Vaccination Status *Vaccinated (Full Program Complete)In Progress (Part Administered)Unvaccinated

Date of Departure from the UK *

Please select today’s date if this is not applicable.
Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date of expected return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Date departing overseas territory for return to the UK *

Please make sure this date is not within the next 6 days to ensure we can fulfill your order.

Countries travelled through in last 14 days? *

Please enter each value separated by a comma e.g: Canada, Germany, Japan

Flight, vessel, train, bus, route number on return to the UK *

Payment Details

Pre departure rapid antigen (Lateral Flow) tests Test 1 *

Price: £10.00

Pre departure rapid antigen (Lateral Flow) tests Test 2 *

Price: £10.00

Pre departure rapid antigen (Lateral Flow) tests Test 3 *

Price: £10.00

Pre departure rapid antigen (Lateral Flow) tests Test 4 *

Price: £10.00

Pre departure rapid antigen (Lateral Flow) tests Test 5 *

Price: £10.00

Pre departure rapid antigen (Lateral Flow) tests Test 6 *

Price: £10.00

Fit to Fly - Witnessed PCR Test 1 *

Price: £130.00

Fit to Fly - Witnessed PCR Test 2 *

Price: £130.00

Fit to Fly - Witnessed PCR Test 3 *

Price: £130.00

Fit to Fly - Witnessed PCR Test 4 *

Price: £130.00

Fit to Fly - Witnessed PCR Test 5 *

Price: £130.00

Fit to Fly - Witnessed PCR Test 6 *

Price: £130.00

Pre departure antigen - WitnessedTest 1 *

Price: £35.00

Pre departure antigen - Witnessed Test 2 *

Price: £35.00

Pre departure antigen - Witnessed Test 3 *

Price: £35.00

Pre departure antigen - Witnessed Test 4 *

Price: £35.00

Pre departure antigen - Witnessed Test 5 *

Price: £35.00

Pre departure antigen - Witnessed Test 6 *

Price: £35.00

Fit to Fly PCR Test 1 *

Price: £120.00

Fit to Fly PCR Test 2 *

Price: £120.00

Fit to Fly PCR Test 3 *

Price: £120.00

Fit to Fly PCR Test 4 *

Price: £120.00

Fit to Fly PCR Test 5 *

Price: £120.00

Fit to Fly PCR Test 6 *

Price: £120.00

PCR Healthcare Screening Test 1 *

Price: £50.00

PCR Healthcare Screening Test 2 *

Price: £50.00

PCR Healthcare Screening Test 3 *

Price: £50.00

PCR Healthcare Screening Test 4 *

Price: £50.00

PCR Healthcare Screening Test 5 *

Price: £50.00

PCR Healthcare Screening Test 6 *

Price: £50.00

Antibody Test 1

Price: £39.00

Antibody Test 2

Price: £39.00

Antibody Test 3

Price: £39.00

Antibody Test 4

Price: £39.00

Antibody Test 5

Price: £39.00

Antibody Test 6

Price: £39.00

+ 1 extra test

Price: £25.00

+ 2 extra tests

Price: £50.00

+ 3 extra tests

Price: £75.00

+ 4 extra tests

Price: £100.00

+ 5 extra tests

Price: £125.00

+ 6 extra tests

Price: £150.00

+ 2 extra tests

Price: £50.00

+ 4 extra tests

Price: £100.00

+ 6 extra tests

Price: £150.00

+ 8 extra tests

Price: £200.00

+ 10 extra tests

Price: £250.00

+ 12 extra tests

Price: £300.00

+ 3 extra tests

Price: £75.00

+ 6 extra tests

Price: £150.00

+ 9 extra tests

Price: £225.00

+ 12 extra tests

Price: £300.00

+ 15 extra tests

Price: £375.00

+ 18 extra tests

Price: £450.00

+ 4 extra tests

Price: £100.00

+ 8 extra tests

Price: £200.00

+ 12 extra tests

Price: £300.00

+ 16 extra tests

Price: £400.00

+ 20 extra tests

Price: £500.00

+ 24 extra tests

Price: £600.00

+ 5 extra tests

Price: £125.00

+ 10 extra tests

Price: £250.00

+ 15 extra tests

Price: £375.00

+ 20 extra tests

Price: £500.00

+ 25 extra tests

Price: £625.00

+ 30 extra tests

Price: £750.00

+ 6 extra tests

Price: £150.00

+ 12 extra tests

Price: £300.00

+ 18 extra tests

Price: £450.00

+ 24 extra tests

Price: £600.00

+ 30 extra tests

Price: £750.00

+ 36 extra tests

Price: £900.00

+ 7 extra tests

Price: £175.00

+ 14 extra tests

Price: £350.00

+ 21 extra tests

Price: £525.00

+ 28 extra tests

Price: £700.00

+ 35 extra tests

Price: £875.00

+ 42 extra tests

Price: £1,050.00

+ 8 extra tests

Price: £200.00

+ 16 extra tests

Price: £400.00

+ 24 extra tests

Price: £600.00

+ 32 extra tests

Price: £800.00

+ 40 extra tests

Price: £1,000.00

+ 48 extra tests

Price: £1,200.00

Payment Handling Fee *

Price: £1.00

Total

£0.00

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Cancellation Terms

In the event that you need to cancel your booking a £20 deduction per package will be made to cover the cost of the kits. For example, one package purchased for £198 will be refunded at £178.

Stripe Credit Card *

Card

Name on Card

FAQ and Term Agreement *

• I have read and understand the FAQ's and Terms

GDPR Agreement *

• I and the people I am buying for consent to having this website store my submitted information so they can process my test. *

Single Line Text

Submit

Terms

• This form is to confirm informed consent for Coronavirus swab testing through 20/30 Labs Ltd
• By submitting the form, the submitter (the donor) consents to provide a swab to 20/30 Labs Ltd for the sole purpose of testing for SARS-CoV-2.
• 20/30 Labs will not use this material to perform any additional tests and collected material will be destroyed after each test is complete
• 20/30 Labs Ltd will only process personal data in relation to the tests for the purposes of conducting the tests and releasing results to the appointed contacts.
• Aggregated, anonymised results may be used for reporting purposes.
• We have a requirement to advise the PHE of any positive samples, therefore if you test positive by signing this form you agree to supply us with the required information. We will only use this information for reporting purposes and it will be deleted from our system after a period of 1 month.