RCI test request form
Form 1A
Please use our test request form (PDF 420KB) to request the investigation of:
- Allo and autoantibodies
- Autoimmune haemolytic anaemia
- Haemolytic disease of the fetus and newborn (HDFN)
- Haemolytic transfusion reactions
- IgA deficiency
Fax confirmation is needed
When requesting a test and sending samples, please ensure you fax (Word 49KB) for confirmation.
Requirements for completing Form 1A and labelling samples
- Refer to our guidance (PDF 633KB)
- Please read the sample labelling policy in Clinical Guidelines for our requirements.
Ordering the form
Please contact your RCI laboratory if you need supplies of the form. This form has been designed based on user feedback.