Important information

Please note that for a full sexual health screen you should have a blood test for Syphilis and HIV. Please contact clinic on 01422 261370 to arrange.

If you are a transgender female or man who has sex with men we would recommend blood testing for Hepatitis A, B and C, Syphilis and HIV. You would also benefit from vaccines for Hepatitis A, B and HPV. Pease contact clinic on 01422 261370 to arrange.  

Home screening is not suitable for individuals who are experiencing symptoms which may be an STI. These symptoms can include, but are not limited to, Pain when urinating, unusual discharge or pain during sex. Where symptoms are present then please contact the clinic to discuss the best options for treatment and support.

Important changes to the Home Screening service

Please note when ordering a kit it is very important samples are taken and returned to us at the clinic, and if kits are not returned, a reminder to return this will be sent via e-mail approximately 3-4 weeks after the kit was requested.  If a sample is still not returned after this reminder then any further requests will not be fulfilled and you will need to ring Broad Street Health Centre and arrange a clinic visit to access STI testing.

Please note we will, on occasion, need to be in touch to complete information if forms are incomplete.

Please note we do not send kits outside of Calderdale and requests from outside this area may not receive a response.

To save time and inconvenience please ensure you are eligible for the home testing service before you complete the form. Calderdale area includes postcodes beginning with;

HX1 to HX7, HD6, OL14 

We are currently experiencing some delays in processing kits which will unfortunately impact on how quickly results can be provided. 

Request a home test for chlamydia screening

Screening Request Form

Basic Information
Screening Kit Options
It is important that we provide the right kit for your needs so we would appreciate it if you could answer a couple more questions for us, as honestly as you can.

If you do not see the Submit button it means you've not answered all the questions under Basic Information. Please go back and make sure all of those are filled out first.

Please note; Where Sex is requested on the form this refers to the sex you were assigned at birth. eg If you were born 'male' then regardless of Gender Identity you would click on the 'male' option, and if you were born 'female' then you would click the 'female' option.