Book a Rapid Test - Rainbow Project

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Book a Rapid Test

Before we contact you to arrange a rapid HIV & Syphilis test we will require some basic information.

Name (you can use fake name if necessary) (required)

Contact Number:

Your e-mail address:

Are You: (required)

Do you currently or have you ever considered yourself as trans? (required)

Do you identify as the following: (required)

Your Age: (required)

Under 18 18-24 25-34 35-44 45-54 55-64 65+

Are you giving us permission to contact you via: (required)

E-mail Text Call Voicemail

Where would you most likely be able to attend a rapid test?

Belfast Derry/Londonderry Newry

Would a morning, afternoon or evening appointment suit best?

Morning (10am-12pm) Afternoon (2pm-5pm) Evening (5pm-8pm)

Why are you needing a rapid test?

Regular check-up I have a concern about my or my partner's sexual health Entering/Exiting a Relationship Issues accessing GUM or other testing services

Any other details that may be relevant

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Daniel McClenaghan

I am a proud straight ally of the LGBTQ+ community. I want to help support the work of the Rainbow project in advocating for and

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Belfast Office
23-31 Waring Street
Belfast
BT1 2DX

028 9031 9030

info@rainbow-project.org

Foyle Office
20 Strand Road
Orlan House
Londonderry
BT48 7AB

028 7128 3030

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Registered with The Charity Commission for Northern Ireland NIC100064
A company limited by guarantee No. NI030101 Rainbow Health Ltd
Registered company office: 23-31 Waring Street, Belfast BT1 2DX

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