Test at home

Get a free test kit

• Simply fill out this form and click send, we'll send you a free test kit.

The kit

We will send you instructions, a swab, a specimen tube and a form which you will need to label with your name, date of birth.

• It's easy

  Just follow the instructions, It's easy to use, painless and totally confidential and you'll get the peace of mind that comes from knowing that you are safe.

• Your test results

  You should receive your results within a couple of weeks. Most people can expect not to have Chlamydia.

Completing this form is giving us permission to send out a postal Chlamydia Screening Pack. Although we send this package out in a plain plastic envelope to the address given, we cannot guarantee it not being opened by a third party or can be held responsible for any issues that may arise from this.

Your details

*Required information

Surname:*

First Name:*

Age (you must be under 25):*

Date of birth:

Male Female *

 

Address

Flat Number / House Number: *

Street:*

Town:*

County:*

Postcode:*

Telephone:

Please note you can only receive your free testing kit by post if you live in the Dorset area.