JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Potters Resort Lateral Flow Test Form
Please register your details and test results here.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Full Name
*
Your answer
Department
*
Your answer
E-Mail Address
*
Your answer
Date Of Test
*
MM
/
DD
/
YYYY
Time Of Test
*
Time
:
AM
PM
Was Your Lateral Flow Test Positive Or Negative?
*
Negative
Positive
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report