HEAD OFFICE
Suite 10 Docnor Centre 
35 Umhlanga Rocks Drive 
Durban North 
4051
South Africa  

0861 10 22 22 ; 031 564 8834
General Information – info@evamed.co.za
locums@evamed.co.za

 

Alternatively you can contact us through the form below. All fields are required:

Your Name (required)

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Any concerns about COVID-19 / Flu like symptoms?

Recent Travel outside of SA?- To high risk areas - name country/s

Contact with a known case of COVID-19 If Yes - name of case


Are they under investigation for COVID-19?
Result - PositiveResult - NegativeResult - Unknown
Personal Symptoms - from when?

Flu Like SymptomsSore ThroatCough?FeverShortness of BreathSelf Isolation - from when?

Comorbidity

ElderlyDiabetesCancerOn Chemotherapy or immune suppressionCOPD/emphysemaRecurrent chest infectionAsthma

Family GP:

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Have you called NICD? If so indicate response below