Request a kit

If you are aged between 15-24 years old and live in the Hampshire area (excluding the Isle of Wight), you can now order a self-test Chlamydia pack, free of charge, by filling out the form below. Your details will be handled securely with total confidentiality.

If you are aged under 16, we will need to contact you before we send a kit.

Your pack will arrive in an unmarked envelope. If you have not received your pack within two weeks of placing your request please contact the Screening Office on 0300 300 2016.

If you do not fit the above criteria we are unable to send you a test kit, therefore please visit www.chlamydiascreening.nhs.uk or phone 0208 327 7436 to find your nearest clinic. We apologise for any inconvenience this may cause.

Name
Address (line 1)
Address (line 2)
Town / City
Postcode

Age	15 or younger 16-24 25 or older

Date of Birth	Day Month Year

Please include your phone number below if you're under 16 years old. Any calls made will be 100% private and confidential.

Telephone

Email *

Where did you find out about postal test packs?
Facebook Search engine Word of mouth Solent NHS Trust Southampton Health Email (Solent NHS Trust) Radio advert Advert Other Letter to home Prefer not to say