Form

HIV reference test referral form

Diagnostic request form (S3) for HIV.

• From: UK Health Security Agency
• Published: 1 April 2014
• Last updated: 7 July 2023 — See all updates

Documents

S3: HIV reference test request form

Ref: UKHSA publications gateway number GOV-14958

PDF, 1.07 MB, 1 page

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Details

Send completed form with clinical samples to:

Virus Reference Department (VRD)

UK Health Security Agency
61 Colindale Avenue
London
NW9 5HT

Email [email protected]

Telephone 020 8327 6017

DX address UKHSA Colindale VRD, DX 6530006

Specimen submission guidelines are available in the VRD user manual

Published 1 April 2014
Last updated 7 July 2023 + show all updates

1. 7 July 2023

   Updated referral form.

2. 4 January 2023

   Added new version of HIV reference test request form.

3. 25 May 2021

   Uploaded new HIV reference test request form.

4. 23 October 2018

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

5. 1 April 2014

   First published.