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Forename Date of birth (not age) OR unique identity number (MRN number, NHS number) For further information, see: Pathology policy for specimen and request form
The consent form gives your gynaecologist the right to do only what is written on this form.
Forename Date of birth (not age) OR unique identity number (MRN number, NHS number) For further information, see:Pathology policy for specimen and request form
would like to be involved in specific projects that we get funded, including co-production and feedback on the patient information sheets and consent form
Date of birth (not age) OR unique identity number (MRN number, NHS number) For further information, see: Pathology policy for specimen and request form
Notes This test is referred externally to the IBGRL at NHSBT Sample Requirements 6ml EDTA The request form and sample must be labelled with Surname
Form 3A is required to request this test (forms available from Transfusion laboratory or downloaded below) H&I Request Form (3A) - Platelet Refractoriness
Apply to be a Young Influencer If you wish apply to be a Young Influencer, please complete the form below. Young Influencers interest form Questions?
taken Time sample was taken Signature of staff member who performed sample taking For further information, see: Pathology policy for specimen and request form
of local guidelines, or if the patient is nil by mouth (or not absorbing) and is prescribed an antibiotic that has to be used in its restricted IV form