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Request forms

Below are our request forms. If you can’t find the form you need or are insure of which form to use please call 020 8266 6510 (between hours of 8am to 8pm).

These forms can also be used if you are unable to submit a request electronically – for example if there is pathology systems downtime.

Forms

Patient details

Each request form must contain the following patient identification criteria:

  • the patient’s NHS or Medical Record Number
  • the patient’s family and given names
  • the patient’s date of birth.

Clinical reporting

It is necessary to interpret the results and display the appropriate reference range of the tests

  • Date and time the specimen was collected
  • The gender of the patient

Pre-printed labels

Pre-printed labels may be used to provide the patient details provided they are attached as indicated on the form itself.

Tests

Tick the appropriate tests on the form or print clearly any additional ones that are not included.

Exceptions

Requests from patients whose identity is incomplete will only be accepted, if they fall into the following categories:

  • Unknown patients attending A&E. These will be identified using agreed, local rules.
  • Forms requesting either Histology or Diagnostic Cytology investigations should include the full name of the consultant together with their GMC number. This will overcome any confusion regarding the identity of the requestor.
  • New born babies without a Given name can be identified as Baby Smith for instance, but must have a MRN number and date of birth.
  • Twins without Given names can be identified using Twin 1, Smith and Twin 2, Smith. Again the MRN number and date of birth must be provided.
  • Specimens from patients attending the GU Medicine clinic need not display all of the Core Identifiers, but only show a unique patient number and the patient’s Date of Birth.
  • HMP patient requests, only display the patient’s DOB and surname
  • Private patients not having an NHS or MRN number. The request should clearly show they are a private patient. The first line of the patient’s address should be included on the request form and written on all specimen containers.

Antenatal screening requests

For requests made as part of the Antenatal Screening Programme, if the individual’s NHS or MRN number is not known their address must be used as the third identifier. In these cases, the first line of the address must also appear on the specimen container.

Latest news

March 12, 2024

Beta D Glucan (BDG) testing brought in-house

At the end of last year, testing for Beta-D-Glucan (BDG) was brought in-house. The median turnaround time using the new in-house assay is around two days, which facilitates a greater impact on antifungal stewardship when the result is negative.

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February 28, 2024

New Abbott Alinity system installed at Epsom Hospital

At the end of last year, a new Abbott Alinity GLP automation system was installed in the laboratory at Epsom Hospital, replacing the existing aging equipment.

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February 7, 2024

Pathology Service Update: Results for renin, aldosterone, androstenedione, 17-hydroxyprogesterone, DHEAS and testosterone confirmation now going out at usual

The delay in reporting results for renin, aldosterone, androstenedione, 17-hydroxyprogesterone, DHEAS and testosterone confirmation reported in January has been resolved and results are now going out as usual.

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January 29, 2024

Salmonella detection to be by PCR only from 1 February 2024

From 1 February 2024, Salmonella detection in faeces will be by PCR only and culture will no longer be routinely performed.

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