Form

Varicella zoster virus referral form

Form (E11) for testing of varicella zoster virus.

• From: UK Health Security Agency
• Published: 1 April 2014
• Last updated: 26 June 2026
  Show all updates

  1. 26 June 2026

     Added new version of form.

  2. 2 June 2023

     Added updated referral form and rebranded diagram.

  3. 2 November 2020

     Updated Varicella Zoster request form to show cessation of VZV IgG avidity service and a note that plasma cannot be tested for quantitative IgG.

  4. 1 April 2014

     First published.

Documents

Varicella zoster virus referral form (E11)

PDF, 843 KB, 1 page

How to take a shingles vesicle swab

Ref: GOV-14742

PDF, 2.47 MB, 1 page

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Details

Print and send completed form with clinical samples to:

Virus Reference Department (VRD)

UK Health Security Agency
61 Colindale Avenue
London
NW9 5HT

Email vrdqueries@ukhsa.gov.uk

Telephone 0208 327 7887

DX address UKHSA Colindale VRD, DX 6530006