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Request forms and sample labelling

For all specimens submitted to the laboratory, a fully completed request form MUST accompany each case.

You may use request forms provided by this department or by your own local histopathology department, as long as it is suitable for histopathology or cytology specimens.

Request forms are designed to provide:

  • unique identification of the patient.
  • a destination for the report and any charging information.
  • the laboratory with the clinician contact details if discussion of the case is required.
  • date and time of specimen collection/removal and investigations required (eg histology/cytology).
  • type of specimen and anatomical site of origin
  • clinical information so that the pathologist may handle the specimen appropriately and interpret microscopic findings in the proper context.
  • an awareness of any health and safety issues with a given specimen.
  • an indication if consent has been provided for research purposes.

With this in mind, please provide complete information on the request form. Failure to adequately complete any portion of a request form may lead to dangerous errors, the responsibility for which will lie with the referring ophthalmologist.

NB: The patient's NHS number should be stated (when applicable), as this provides a unique identifier, together with patient's first and last names, date of birth, gender, hospital number (if appropriate). Patient address is also required for cases originating outside of CMFT.

Each specimen container, no matter how small, must also be labelled with the appropriate patient identification data (minimum of 3 identifiers eg first and last name, date of birth/age, gender and preferably patient's NHS/Hospital No). The information must be consistent with the request form, to prevent errors in specimen and patient identification. Multiple specimens from the same patient should also identify the specimen type/site.

If there are discrepancies between the request form and specimen labelling, specimens in inadequately labelled containers or accompanied by inadequately completed request forms; the requesting clinician will be required to complete the documentation by visiting the laboratory or the specimen may be returned to the referring clinician for proper completion, resulting in a delay in processing.


(Last reviewed 30th May 2017)