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

NYSC COVID-19 Test Form

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

RDT Test sample collection

Sample Collection Centre
NYSC Orientation Camp Community
NYSC Callup No

Read – NYSC Timetable and Registration Update

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

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

Previous Covid-19 test

Have you taken Covid-19 test before?

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?

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?

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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