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Staff Covid Home-Testing Record
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* Required
Name
*
Your answer
Date of Test
*
MM
/
DD
/
YYYY
Result of Test
*
Negative
Positive
Void
Result uploaded to the NHS (You must report your result to the NHS)
www.gov.uk/report-covid19-result
*
Yes
No
Did you have any issues that you have reported? In the unlikely event of you having issues with your test kit such as missing items or if you have been harmed or had a reaction whilst taking the test such as a swab breaking in your mouth, bleeding or an allergic reaction you should report it here
https://coronavirus-yellowcard.mhra.gov.uk/
*
Yes
No
What were the issues you have reported?
Your answer
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