NYSC COVID-19 Test Form – NYSC NCDC Covid-19 RDT Testing Verification Slip

NYSC has mandated nysc batch A, B, and C candidates to complete the NYSC NCDC Covid-19 RDT online form as a criteria and requirement for clearance in camp.

NYSC COVID-19 Test Form – NYSC NCDC Covid-19 RDT Testing Verification Slip

It is compulsory that you complete this NYSC COVID-19 Test form .

Fields marked  are required

  1. RDT Test sample collection
  • Sample Collection Centre
  • NYSC Orientation Camp Community
  • NYSC Callup No

Read – NYSC Timetable and Registration Update

  1. Person Identification Information
  • Firstname(s)
  • Surname
  • Sex
  • FEMALE
  • Date of birth
  • Telephone number (Mobile)
  • Email
  • Address of Residence
  • Address
  • State of residence
  • LGA of residence
  • Ward of residence
  • Village/Landmark
  • Country of residence
  1. Person symptoms (from disease onset)
  • Have you had any of the following symptoms within the last 2 weeks.
  • Fever (≥38 °C) or history of fever
  • Sore throat
  • Runny nose
  • Cough
  • Shortness of Breath
  • Vomiting
  • Nausea
  • Diarrhea
  • Tiredness
  • Chest pains
  • Red eyes
  • Loss of taste
  • Loss of smell
  • Headache
  • Any other symptom
  • Date of first symptom onset
  1. Previous Covid-19 test

Have you taken Covid-19 test before?

  1. Human exposures in the 14 days before illness onset
  • Have you returned from local travel within the last 14 days?
  • Have you returned from international travel within the last 14 days?
  • In the past 14 days, have you had contact with anyone with suspected or confirmed COVID-19 (corona/coronavirus)?
  • In the past 14 days, have you attended any event?
  • Have you visited or been admitted to any inpatient health facility?
  • Have you visited any outpatient treatment facility?
  • Have you visited any traditional healer?
  1. Behavioral
  • How often do you avoid people who are sneezing or coughing since the beginning of the pandemic?
  • How often do you avoid large gatherings since the beginning of the pandemic?
  • How often do you avoid touching your face, mouth, eye or nose since the beginning of the pandemic?
  • How often do you wash hands with soap and water since the beginning of the pandemic?
  • How often do you attend or visit public places since the beginning of the pandemic?
  • How often do you avoid public transportation since the beginning of the pandemic?
  • How often do you avoid non-essential travel since the beginning of the pandemic?
  • How often do you use alcohol-based hand sanitiser since the beginning of the pandemic?
  • How often do you wear a mask outside your home since the beginning of the pandemic?
  • How often do you maintain a distance of at least 1.5 meters from the person next to you since the beginning of the pandemic?
  1. Belief Surrounding Covid-19
  • I am worried about the likelihood of getting COVID-19
  • The chance of getting COVID 19 in the next few months is high
  • Contracting COVID-19 is possible
  • The complications of COVID-19 are serious
  • I may become very sick if I get COVID-19
  • COVID-19 can lead to death of an infected person
  • Measures such as washing your hands frequently and wearing of face mask reduces the risk of contracting COVID-19

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