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Please enter a valid email address.

We will only use this to call you if there is any problem with your email address, or to send a text reminder if you book a screening appointment.

Your answer should be no more than 4 characters long.

Dates need to be in the format 'DD/MM/YYYY', for example 27/03/1980.

(dd/mm/yyyy)

6.6. Are you registered with a GP Practice in the UK? Required
7.7. Are you currently taking any medication? Required
8.8. Have you ever had a BCG vaccine? (Vaccine against tuberculosis (TB). Usually leaves a scar on your arm)
9.9. Are you currently under the care of, or waiting forĀ an appointment with, a hospital specialist? Required
10.10. Are you currently taking part in a clinical trial involving a vaccine or giving blood? Required
11.11. Have you ever been diagnosed with Tuberculosis? Required
12.12. Have you ever been diagnosed with asthma or another respiratory disease? Required
13.13. Have you ever lived in a tropical country for a consecutive period of 12 months? Required
14.14. Are you a current smoker? (Current smoker is someone who currently smokes or has stopped smoking less than 3 months prior to filling out this questionnaire. It includes vaping or smoking other drugs.) Required
15.15. Are you living with anyone who is immunosuppressed (has a poor immune system)? This would include any of the following: currently pregnant, taking oral steroids or other immunosuppressive drugs within the past 3 months; has had a splenectomy; has known immunodeficiency or HIV; treatment with chemotherapy or radiotherapy in the past 6 months; recent bone marrow/organ transplant. Required
16.16. How did you hear about us? Required

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