Diagnostic Blood Test Request

This form is not to be used to request routine or recall bloods.

If you are requesting recall or routine bloods please use this link

This form is for you to request your own blood tests that you may feel you require for any ongoing symptoms you may be experiencing.

This form is not suitable for patients under 12 years.

once a clinician has reviewed the information you have provided we will assess if blood tests are required and request the most relevant tests. You will then receive a text message from the clinician letting you know that you can then proceed to book in for a blood test via the local Phlebotomy Service

DO NOT BOOK IN WITH THE PHLEBOTOMY SERVICE WITHOUT PRIOR DISCUSSION WITH THE GP. THEY WILL NOT TAKE YOUR BLOOD UNLESS THE GP HAS REQUESTED IT.

Should the clinician require additional information before being able to make a decision about bloods then you will be invited for a telephone consultation.

Please use format day/month/year e.g. 12/05/1979
Enter Email

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.