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All external users should complete the external request form. 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. 

Please find and download the relevant request forms below. Please contact  the Molecular Specimen Reception on 0121 371 3325 or This email address is being protected from spambots. You need JavaScript enabled to view it. with any queries regarding the request forms.

Lung Cancer Testing
including EGFR, ALK, PD-L1 & ROS


Lung Cancer Request Form
EGFR Mutation Testing on Circulating Tumour DNA


EGFR Circulating Tumour DNA Request Form
Colorectal Cancer Testing
including KRAS, NRAS, BRAF, MMR IHC & MLH-1 
 Colorectal Cancer Request Form
GIST Testing
including KIT & PDGFRA and BRAF 
 GIST Testing Request Form
PD-L1 Lung Cancer Testing Prior to Pembrolizumab Therapy
including PD-L1 22C3 IHC
 PD-L1 Lung Cancer Request Form
PD-L1 Bladder Cancer Testing Prior to Pembrolizumab or Atezolizumab Therapy
including PD-L1 22C3 IHC & PD-L1 SP142 IHC
 PD-L1 Bladder Cancer Request Form
PD-L1 Breast Cancer Testing
 PD-L1 Breast Cancer Request Form 
Melanoma Testing
including BRAF, NRAS, KIT and PD-L1 28-8 
 Melanoma Testing Request Form 
Breast and Gastric Cancer Testing
including IHC & FISH 
 Breast and Gastric Cancer Request Form 
Neuropathology Molecular Testing
 Molecular Neuropathology Testing Request Form 
Thyroid Cancer Molecular Testing
including IHC & PCR 
 Thyroid Cancer Testing Request Form 
PD-L1 Head & Neck Cancer Testing
including 28-8 & 22c3 
 Head & Neck PD-L1 Request Form 

 

Molecular Pathology - Request a Test

 

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Protection of Personal Information – Clinical Laboratory Services comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.

University Hospitals Birmingham medical laboratories at Queen Elizabeth Hospital, Heartlands Hospital, Good Hope Hospital and Solihull Hospital are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

  • Molecular Pathology is a UKAS accredited medical laboratory No. 8759
  • Biochemistry is a UKAS accredited medical laboratory No. 8910
  • Haematology and Transfusion is a UKAS accredited medical laboratory No. 8784
  • Clinical Microbiology is a UKAS accredited medical laboratory No. 8760
  • Cellular Pathology is a UKAS accredited medical laboratory No. 10141
  • Musculoskeletal laboratory is a UKAS accredited medical laboratory No. 9897
  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217.

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://qehbpathology.uk/test-database

For further information contact Louise Fallon, Quality Manager, 0121 371 5962