Symptomatic COVID-19 Testing Form

The testing criteria for coronavirus has changed. Any patient who was previously referred prior to 25th March for testing and did not receive an appointment will now not be tested. Please contact the practice again to be assessed for suitability for testing.

Due to the increased volume of phone and email queries about Coronavirus testing in light of broadening of testing criteria announced by the HSE - we are now asking symptomatic patients to fill out the following questionnaire to help us assess you more efficiently.

We understand our patients are concerned for themselves and their loved ones and we can assure you we are doing everything we can to operate as normally as possible in these extraordinary times, while at the same time minimising the risk of exposure to our patients or our practice.

PLEASE NOTE THIS FORM IS ONLY FOR PATIENTS REGISTERED WITH WEST COAST MEDICAL

Anyone using this form who is not registered will not receive a call back and their details will not be forwarded onto the testing service.

By submitting this form, I consent to my data being transferred to West Coast Medical for screening. I agree to take responsibility to follow up with the GP practice if I have not heard back in 48 hours.

Next Steps

• On receipt of the form, one of the practice doctors or nurses will contact you to confirm receipt and clarify any issues via phone consultation if needed
• If you meet the current criteria for Covid-19 testing as outlined by Health Protection Surveillance Centre Guidelines, we will submit an e-referral to request Covid-19 testing to the National Ambulance Service (NAS).
• We will send you a text message to confirm that the referral has been sent.
• NAS will contact you directly to arrange this and give further information. This may take a number of days depending on demand and we have no way of speeding this up, please be patient.
• If your symptoms worsen whilst you are awaiting testing, please contact us so we can further evaluate your status.
• While you are awaiting for us to contact you, please, please, please self-isolate at home to help slow the spread of the virus.
• Please do not come in to the practice as you risk passing on infection to other patients and our staff.
• Further information:
  • Useful information on self-isolation, can be found on the HSE’s information page here.
  • Useful information on the virus can be found on the HSE Covid-19 page here.
  • For travel advice, please visit the Department of Foreign Affairs Travel Advisory page here.

Please be sensible and follow all official advice coming from HSE and public health. Please avoid putting any vulnerable groups in the population at increase risk unnecessarily.

Please look out for each other, especially any older and more isolated friends and family. Practice social distancing, cover your coughs and sneezes. Most importantly, wash your hands. And then wash them some more!