Service > Request Form

Request Form

The request form must be completed for every patient specimen sent to bioscientia. The form must be completed correctly and clearly, this will facilitate bothefficient and accurate processing of the sample.

NB: The printing of request forms within Bioscientia takes approximately 3-4 weeks. Please allow sufficient time when re-ordering your request form supply.

REQUEST FORM DETAILS AND COMPLETION ADVICE

Bioscientia request forms are printed specifically for each client. Only use request forms with your client number and address printed on the form.

  • Client address
  • Barcode
  • Client number

Failure to use forms that are “client specific” will result in delays and possibly even lost samples. The address and client number form the main basis of patient identification and results.

2. Patient details

Please print clearly and concisely in the Patient detail box, the patient name, sex and date of birth.

  • Patient name
  • Patient sex
  • Date of birth
  • ID number
  • Clinical comments: If possible please give clinical details which may assist the interpretation of results (mandatory for chromosome, molecular and down syndrome analyses).

3. Specimen data/sample type

Please refer to the test list for correct sample requirements before sending to bioscientia.

  • Quote the date the sample was drawn along with the time
  • Indicate the type of sample was sent
  • Quote week of gestation if relevant to the test being required
  • Quote faeces weight or urine volume if relevant to the test
  • Quote weight/height if test relevant i.e. for creatinine clearance
  • Quote how many tubes sent in total with this request

4. Analyses required

Do not use red ink or marker pens. Mark appropriate box clearly

  • Put a clear line across the box for the test required
  • For any test not listed on the request form print the name of the test clearly under the “Other Analyses” section and mark the box as under point 4.a

5. Labels:

  • Put the label(s) on the tube (s) from the patient concerned (do not use for other patients) and then send with the request form to Bioscientia. Any labels not needed should be discarded
  • Stick this label on to the copy of the request form (separate copy from original before sending to us) and keep the copy for your files with this barcode number on it, for your reference.

 

ONLY USE BIOSCIENTIA PERSONALIZED REQUEST FORMS

Molecular Genetic Analysis
Cancer Genetics
Prenatal Screening (Biochemical Genetics)
Prenatal Diagnostics
Chromosome Analysis Postnatal
Array-CGH
Allergy Request Form
General Request Form
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