RCI Test Request Form

Please use the 1A test request form to request the investigation of:

• Allo and autoantibodies
• Haemolytic transfusion reactions
• Haemolytic disease of the fetus and newborn (HDFN) 
• Autoimmune haemolytic anaemia
• IgA deficiency

The form collects clinical details required for us to carry out tests that are compliant with accreditation regulations.

Documents

• Test request form (FRM1597/4.2) 
• How to complete the test request form (INF417/1.1)
• Requirements for completing the test request form and labelling samples - please see MPD63 in Clinical Guidelines 

Please contact your RCI laboratory if you need supplies of the form. This form has been designed based on user feedback.