Paper Request Form Completion

Essential Requirements

A completed request form must accompany each patient sample. It must contain the following correct information to avoid the whole request being rejected:

  • Last Name and First name(s)
  • Date of birth
  • NHS number
  • Clinical Information
  • Signature (Transfusion, Histology, Cytology)
  • Antibiotic therapy (Microbiology)

Desirable Information

  • Requesting practitioner and location - to return results/contact
  • Type of specimen and where it was obtained
  • Date and time of specimen collection
  • Fasting status
  • Request priority

If we don’t know unequivocally who the patient is (both form and specimens), we cannot analyse their specimens. If we don’t know who or where the request comes from, we cannot send a result out. If there are no helpful pieces of clinical information given, then we cannot provide our best service to you. Only information given on the request form will be returned to you, so if you are relying on the returned data as an aide memoire in addition to giving you results, please fill in all fields legibly.

Last updated: October 28, 2019