Thank you for choosing Mediclinic Middle East.

To request a PCR test, please fill in the information below.

Samples are analysed in Mediclinic City Hospital’s in-house laboratory.

Mediclinic issues all negative PCR tests  results automatically via SMS  and email. Please ensure the Emirates ID/passport number, mobile number, email and date of birth are correct.

All fields marked with * are mandatory to coordinate your request.


Number of patients registered (please list all the patients’ details as indicated)

Reason for Test

You should proceed to the emergency department.

You should proceed to the emergency department.

Does the patient present any signs and symptoms?

You should proceed to the emergency department.

Does the patient have a history of travel in the last 14 days?
Did patient have close contact with a person who is under investigation for Covid-19 while that person was ill?
Does the patient present with any comorbid conditions?
Is/was the patient Hospitalized?

Is/was the patient admitted to ICU?

Is/was the patient intubated?

Is/was the patient On ECMO?

Does the patient have any direct contacts?
Have the contacts been tested?

Does the patient live in a labor camp?
If (Yes) please fill the fields below.

Have history of being in a healthcare facility ( as a patient, worker, or visitor) during the last 14 days?

Detection Facility:


Educational Institute Type:

Education Type:

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This field is required.