BOOK A TEST A request form must accompany every sample submitted to the laboratory. The request form must contain all our required information in order to have the specimen processed. The essential elements of the request form are: Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Patient's First & Last Name *FirstLast Hospital on Sex Patient's Hospital Number Patient's Date of BirthAgeSex * Male Female Requesting Physician's First and Last Name *FirstLastRequesting Physician's Phone NumberDate / Time of CollectionDateTimeSource of Specimen Provisional Diagnosis Specify antibiotic therapy if patient is or recently was on any antibioticIndicate The Test(s) Requested RENAL/BONE/ELECTROLYTE TESTSLIVER/PANCREATIC TESTSDIABETES TESTSCARDIAC AND LIPID TESTSOTHER CLINICAL CHEMISTRY TESTSTHYROID TESTSFERTILITY/REPRODUCTION/PITIUTARY TESTSTUMOUR MARKERS TESTSHAEMATOLOGY TESTSINFECTIVE SEROLOGY TESTSMICROSCOPY, CULTURE & SENSITIVITY TESTSVENEREOLOGY TESTSFULL CHECK UP/ ROUTINE CHECK UP TESTSBook Now
