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Documents & Forms

MEASLES – How to Take a Mouth Swab:

How to take a mouth swab: use a dry swab and rub along the gum line for 2min (Figure 1) and send either in a universal container or in Cobas PCR media (Figure 2).

Please do not send a gel swab as this cannot be processed

Fig. 1

Fig. 2

RVL BELFAST Referral Forms:

Virology General Request Form (M-2037 V2)

Rapid Testing Respiratory Illness (M-2273 V4)

Measles Investigation Request Form (M-2059 V2)

Investigation of contact with confirmed measles case in pregnant or immunosuppressed patients (M-2589 V1)

Occupational Health Screening (M-1736 V6)

Reproductive Health Services Request form (M-2556 V1)

Renal Dialysis Request Form (M-1271 v4.0)

GUM Clinic – Virology Request Form (M-1315 v8.0)

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

HIV-1 Genotypic Resistance Form (M-2567 V1.0)

Varicella Contact in Pregnancy (M-1978 V3)

Congenital Syphilis MOTHER (M-2477)

Congenital Syphilis INFANT (M-2478)

Fetal Ultrasound (M-1555 V5)

Milk Donor Request Form (M-2058 V3)

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

Pre Biologic Screen (M-1732 V5)

CMV Colitis (M-1724 V5)

Post Bone Marrow Transplant Monitoring (M-1319 V5)

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

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

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

Lyme Disease Serology (M-1874 V5.0)

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)