Form

HIV reference test referral form

Diagnostic request form (S3) for HIV.

• From: Public Health England
• Published: 1 April 2014
• Last updated: 23 October 2018, see all updates

Documents

S3: HIV reference test request form

PDF, 322KB, 1 page

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

Send completed form with clinical samples to:

Virus Reference Department (VRD)

Public Health England
61 Colindale Avenue
London
NW9 5HT

Email vrdqueries@phe.gov.uk

Telephone 020 8327 6017

Fax 020 8327 6559

DX address PHE Colindale VRD, DX 6530006

Specimen submission guidelines are available in the VRD user manual

Published 1 April 2014
Last updated 23 October 2018 + show all updates

1. 23 October 2018

   Updated page to simplify the 'clinical and epidemiological information' section. In addition, added information on PreP exposure.

2. 1 April 2014

   First published.