AirPort Test Booking
请务必认真填写，提交成功后无法修改任何信息
Please fill in carefully, you cannot change information after submission
Personal Information 个人基本信息
我自愿预定诺华美检测中心服务，如果因为不可抗拒原因造成我旅行计划改变诺华美不承担任何责任！
I claim that I am booking voluntarily through Novamedik Testing Service and I will be responsible for all travel plan changes due to test report delay or missing if it happens!
我声明自愿把我个人信息提供给诺华美检测中心以便进行新冠检测之用途
I voluntarily provide the following information to Novamedik test center for short-term COVID test only
我自愿但匿名提供我的新冠检测结果给有关监管和科研机构进行疫情监控分析研究
I allow disease control and scientific research institutions to use m y test result anonymously for pandemic control related research and analysis
请上载护照首页。(图片大小不超过3MB)
please upload your passport first page（picture size < 3MB）
Select
请上载您飞往中国的机票或行程单（必须真实），不飞中国旅客上载飞往目的国机票 。(图片大小不超过3MB)
please upload your flight ticket to China. If you are not flying to China, upload ticket to your destination country.（picture size < 3MB）
Select
Full Name 护照拼音姓名
Gender 性别
Male 男性
Female 女性
Neutral 中性
Date of Birth 生日
Passport number 护照号码
For Hong Kong,Macau and Taiwan residents,please fill in the same ID number as initial departure country 港澳台同胞请填写和始发国绿码一致的证件号
E-mail 电子邮件
From Which Country To Amsterdam 始发国
Arriving Amsterdam Airport Date (GMT+1) 到达荷兰时间（阿姆斯特丹时间）
Destination Country 最终目的国
Fly to Amsterdam Airport Flight No. 飞往阿姆斯特丹机场航班号
Leaving Amsterdam AirPort Flight No. 离开阿姆斯特丹机场航班号
Appointment Test Time 预约检测时间
Date and time leaving Amsterdam (GMT+1) 离开阿姆斯特丹时间（阿姆斯特丹时间）
Telephone 联系电话
Test Type 检测类型
IF you are NOT flying to China choose PCR Only or Antigen Only 不飞往中国的旅客请选择PCR Only 或者 Antigen Only
Please choose your test： 请选择检测项目：
PCR Only
Double PCR for China
PCR + IgM for China
Antigen Only
Do you hold a NEGATIVE Covid-19 test report within 48h?是否有48小时内核酸检测 阴性 报告
Yes 是
No 否
Have you been vaccinated against Covid-19? 是否注射过 Covid-19疫苗
Yes 是
No 否
Have been infected by COVID? if yes, when did you recoverd (last negative PCR) 是否感染过 Covid, 如果是，何时痊愈的 （最后痊愈报告日期或核酸转阴日期）
Yes 是
No 否
Recovered Date 康复日期
vaccine Type 疫苗类型
中国疫苗 Sinovac
Pfizer
Merdena
BioNtech
GSK
BARDA
Other
Name other vaccine其他新冠疫苗名称
Level of Antibody 抗体水平
Date of completing full COVID vaccine 新冠疫苗完成注射时间
Submit 提交
Please print and bring this QR Code with you. 请打印并携带此二维码！
confirm 确认
