RVL Belfast Referral forms:

Virology General Request Form (M-2037 V2)

Rapid Testing Respiratory Illness SARS-CoV2 & Influenza Request Form (M-2273 V2)

Virology Request Form GUM (M-1315 V5)

CTNG non-GUM Request Form (M-2060 V3)

Congenital Syphilis MOTHER (M-2477)

Congenital Syphilis INFANT (M-2478)

Fetal ultrasound anomalies Form (M-1555 V4)

COVID Anti Spike antibody test Request form (M-2250)

Patient Pre-Biologic Screen (M-1732 V4)

Varicella Contact In Pregnancy (M-1978 V2)

Investigation of Parvovirus B19 in pregnancy (M-1343 V3)

Occupational Health Screening Form (M-1736 V5)

Occupational Health NSI Form (M-1940 V3.1)

Molecular influenza/respiratory virus request form (M-1396 V3)

Milk Bank donor screen request form (M-2058 V2)

Measles investigation request form (M-2059 V1)

Virology for patients with suspected CMV colitis (M-1724 V3)

Lyme disease serology request form (M-1874 V4)

Meningococcal Pathway (M-1375 V3)

P. aeruginosa VNTR typing (M-2057 V3)

C. difficile Ribotyping Request (M-2062 V2)

 

Request forms for Referral Tests:

Rare and imported pathogens (P1)

Intrathecal Antibody Request Form (E22)