Cytogenetics referral form
A fully completed cytogenetic referral card should accompany each sample. These should be legible and fully completed with all relevant information, including:
- Patient name (first and surname)
- Date of birth
- Address and post code
- NHS number
- Referring consultant and referral centre (where the report is to be addressed)
- Referring doctor’s contact telephone number
- GP/GP code and GP practice/practice code
- Relevant clinical details and test(s) required. This may include names and other clinical information of relevant family members.
- Sample type
- Date of sample collection
- If a sample is urgent please indicate why
- For prenatal or abortus samples please indicate gestational age
- If a sample is high risk please indicate the risk and contact the department in advance. See High Risk Samples.
Please follow the link for the genetics referral card. Please follow this link for guidance for completion of the genetics referral card.
All samples should be labelled with at least three patient identifiers. These should include:
- Patient name (first and surname count as two identifiers)
- Date of birth
- NHS/hospital number
The sample should also state the date of collection and be accompanied by a completed referral card. Referrals should be sent to the Cytogeneics department on the same/next working day depending on sample type, please refer to the relevant sample type page within this website. For sample transport information including storage before dispatch please refer to Transportation of samples.
For specific sample requirements please see the appropriate page under services and tests.
In submitting a sample, the clinician confirms that consent has been taken for cytogenetic testing and possible storage. Please see the reverse of the genetics referral card for consent requirements.
Acceptance and rejection criteria
If the sample or referral card is inadequately labelled it may lead to rejection of the sample. For referrals that are not easily repeatable and are not adequately labelled, or suboptimal*, processing may be attempted. The final report will include an explanation of the labelling of the sample and referral card on receipt in the laboratory. Samples in the wrong tube may be rejected, please see services and tests for specific sample type acceptance and rejection criteria.
*Suboptimal may include small samples, those delayed in transit, those not stored correctly and specimens received in the wrong container.
Page last updated 12/02/2018 by MC. Please note that if printed, this information is only valid on the day of printing.