Requesting a cervical screening test
Electronic requesting for cervical screening tests is available
to all GP practices via a system called ICE Desktop. This will
eliminate the need to complete paper copy request forms and ensure
all mandatory information is provided. If ICE Desktop is
unavailable at any point, sample takers will have the option to
complete a paper request form or download and print a form directly
from Open Exeter.
Open Exeter request form
The electronic HMR101 request form can be downloaded from Open
Exeter for those sample takers who have been trained in the use of
this form. Training guidance can be provided by contacting PCSS
(Preston). Please print off the form and complete it paying
particular attention to the provision of relevant clinical
Information relating to previous histology biopsies (punch,
LLETZ/loop, cone, etc) with histology grade and date of biopsy, as
well as details of any treatment are ESSENTIAL to ensure correct
patient management is given.
The version to use is HMR101 form A5 PDF (2009). This document
will be pre-populated with the forename, surname, date of birth and
NHS number, as well as the date of the previous test. Also printed
on the form is the cervical cytology history for the woman.
If you require any support in accessing the request form on Open
Exeter, please contact LASCA:
Head of Contractor and Patient Services
Elaine Jones 01772 221 340
Screening Development Manager
Pauline Fisher 01772 221 345
HMR101 form A5 PDF (2009)
Printing the HMR101 form - if possible please print in 'portrait
format' to facilitate use in the laboratory.
Don't forget to print your name and your GMC or NMC
(Last updated January 11th 2017)