Home · בדיקת קורונה מהירה

טופס רישום לבדיקת קורונה מהירה

There is permission not to pay

NoYes

Payment Method

Total

Receipt No.

Location

Queue

Requested Date

Requested Hours

Israeli ID / Passport

ID Num

FirstName

LastName

BirthDate - day (1-31)

BirthDate - month (1-12)

BirthDate - year

Age

Mobile Phone

City

Street

Home No.

HMO

For Flight

If the check is for a flight, enter a passport number and name in English as it appears in the passport

NoYes

Last Name in English

First Name in English

Passport Number

You can purchase a personal card that gives 10 tests for a period of two months at a cost of 320 NIS. In the next registration, the system will identify your ID number and take advantage of the remaining samples you will have.

Are you interested in purchasing a tab?

NoYes

Explanation of the significance of the test results and the guidelines of the Ministry of Health:
https://yosiamar.com/corona-fast

I confirm that:
1. Sample details are correct
2. I confirm that if the test result is positive, the test results and the sampled details will be sent to the Ministry of Health and the HMO, according to the guidelines of the Ministry of Health
3. I confirm that I understand the significance of the test results

Signature

Children under the age of 18 must complete parental consent

Guardian Name

Guardian ID

Proximity

Upload the certificate to the system