Use the buttons below to download the appropriate request form. Each form contains instructions and requirements to their respective tests. If you can't find what you're looking for, please get in touch. We ask that the forms are completed in full and if handwritten, in block capitals so that the form is legible. Missing information could lead to a delay in testing as some information is vital in order for a case to be booked in. 


The use of patient ID stickers is permitted however please ensure you use the full patient sticker NOT the smaller blood tube sticker. All specimens received into MPDS must meet the agreed laboratory minimum data set; any specimens not meeting the criteria may be returned to the requesting department. Please ensure that any important information (e.g. clinical history, etc.) is clearly indicated on the form and ensure that any priority or urgent cases are marked as such.

Where possible a copy of the pathology report should be provided.


It is the responsibility of the sender of the specimen to arrange safe and appropriate packaging and transport of specimens that meets national/international regulatory requirements for the transport of biological specimens. If multiple patients are being sent in a single package then these should be separated individually within the package and referral forms attached to each individual specimen container. Blocks from different patients should not be kept in direct contact with one another.

 

Useful information...


Transport from external sources

It is the responsibility of the referring centre sending the specimen to arrange appropriate transport to MPDS. We recommend that all samples posted are sent via recorded/tracked delivery. QEHB are not responsible for any samples that go missing between the referring centre and QEHB.

Transport of Specimens at QEHB

It is the responsibility of the department sending the specimen to arrange appropriate transport to MPDS. This can either be through the internal post system or hand delivered. If a sample is being dropped off at the CLS Specimen Reception, we ask that you contact the Molecular Specimen Reception on Ext: 13325 to alert us that the sample has arrived.

 

Hazardous Specimens

Specimens arising from patients with known or suspected transmissible diseases (e.g. tuberculosis, viral hepatitis, HIV) must be clearly labelled as such and packaged appropriately to prevent unnecessary risk to laboratory staff. 

Minimum Dataset

Submitted request forms must include:

  • SURNAME
  • FORENAME (NOT JUST INITIALS)
  • DATE OF BIRTH
  • HOSPITAL ID &/OR NHS NUMBER
  • BLOCK ID
  • SEX
  • LOCATION

Submitted samples must include:

  • BLOCK ID

 

  • REPORT DESTINATION
  • REQUESTING PRACTITIONER
  • CONSULTANT (IF DIFFERENT FROM ABOVE)
  • CLINICAL DETAILS
  • DATE SAMPLE SENT
  • SPECIMEN TYPE (& SITE IF APPROPRIATE)
  • INVESTIGATIONS REQUIRED

General Information

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Location of Laboratories

Where the laboratories are located and information about the services offered at each laboratory