Return to Home Page


Direct On-Line Booking

Pathology Laboratory Samples

Items marked ## MUST be completed ##
## Account Number >
BAM Request
## Date of Dispatch >

Serology Request
  Today - Check
GI Outbreak request
## Time of Collection >
TB Request
## Ref :
##

Food Poisoning Request
## PICK-UP Location >>

or >> Address

ONLY if completed "Address" above
##
## Drop Off Laboratory>>

or >> Address

ONLY if completed "Address" above
Additional Data or Instructions
(Contact Precautions, Special Precautions etc)
## Booked by [ First & Last Name ]
Cost Code
## Senders Email Address
## Receivers Email Address
##Telephone Number
            Ext