FORM
COVID-19 TEST REQUEST

Cambiar a la version en español
Passage à la version française


Click HERE if you have already filled out this form before!


Name and last name (passport)
Passport number

Birthdate
Month: Day: Year:



Age

Address in Costa Rica
Reason for the test
Nacionality
Phone number
E-mail address
 
Secundary E-mail (Optional)
 
Language of the result
PDF file in?




Select the type of test you need
PCR or Antigen?




Flight Information
¡Important to know when is the right time to test!
Departure date:
<December 2024>
SunMonTueWedThuFriSat
1234567
891011121314
15161718192021
22232425262728
293031

Please select the departure date


Click HERE to search for available spaces








Send form







Hoy lunes 9 de diciembre abierto de 7:00 am a 1:00 pm / 2:00 pm a 4:00 pm
[  Horario de atención  ]


Jaco Walk, local #5
Garabito, Puntarenas, Costa Rica

Mapa del sitio

© Laboratorio Jaco | 1999 - 2024
laboratoryinjaco.com