Legal & Ethical Disclaimer: The following form that is filled up is to just try to help get your information shared out to different covid centers who are associated with us directly or indirectly. This is not a registration form that guarantees admission to any hospital whether it be covid or non covid in nature. This form is to just collect information that you agree to share and which we manually forward to medical centers to see if any of them have availability and if so, to assist you by calling you directly (not through us). The health centers take up the request in their own little way, if they can however for specific hospital or medical center booking you should always go directly than through this form. This form allows you to download it into pdf which therefore allows you to share this directly to the medical center for assistance. We do not guarantee or even promise or even suggest that you are in any sort of queue with any medical center. Our job is to simply forward your application to medical centers and then move out of the relationship then and there. Available health care centers will contact you from that point and our role of referring your case is done with. You agree we are not liable to absolutely anything via this form and you are using it only at your own discretion, holding us not responsible for anything. Of course, and mainly you should use this form with complete understanding of the above and agree not to hold us liable in any possible way. Please always take a competant doctors advice first before filling up this form and understanding 100% each and every line and sentence (We offer no registration or queueing up). 99% of the time your request will not get a reply so it’s best to contact hospital, lab or covid doctor in advance and go through them. 1% chance (or less) that you will get a call back using this form. However if you are okay with the less than 1%, feel free to fill this up.