Form

Varicella zoster virus referral form

Form (E11) for serology testing of varicella zoster.

• From: UK Health Security Agency
• Published: 1 April 2014
• Last updated: 2 June 2023 — See all updates

Documents

Varicella zoster virus referral form (E11)

Ref: GOV-14742

PDF, 1.2 MB, 1 page

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How to take a shingles vesicle swab

Ref: GOV-14742

PDF, 2.47 MB, 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@ukhsa.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

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

Published 1 April 2014

Last updated 2 June 2023 + show all updates

1. 2 June 2023

   Added updated referral form and rebranded diagram.

2. 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.

3. 1 April 2014

   First published.