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 (surname in full) department 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
- The urgency of a sample together with reasons for that urgency
- For prenatal or abortus samples please indicate gestational age
- If a sample is a known infection risk please ensure this is recorded on the referral card. Indicate the risk with as much detail as possible and contact the department in advance. See High Risk Samples page for containment levels.
Please follow the link for the Laboratory Genetics Referral Card.
It has come to our attention that some of our old referral forms are still in use, which reference CPA (Clinical Pathology Accreditation). These forms are fine to use, however, we wish to draw your attention to the fact that the United Kingdom Accreditation Service (UKAS) is the sole national accreditation body for the UK and CPA no longer exists. You will be pleased to hear that the Nottingham Cytogenetics Service is a UKAS accredited laboratory No. 8031.
*Clearly stating the referring clinician and the referral centre is necessary to ensure the resulting report is sent to the correct location. Failure to provide this information may delay testing or result in the report being sent to the incorrect location. This information is also essential to ensure that referral centres are invoiced for the correct tests.
For bloods referred for karyotyping, a lithium heparin (green cap tube) should be used.
For bloods referred for microarray testing, an EDTA (purple cap tube) should be used.
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 Cytogenetics 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 Laboratory 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 are 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.
High risk samples will be rejected if they cannot be handled at our containment level. See high risk samples page for containment levels.
*Suboptimal may include small samples, those delayed in transit, those not stored correctly and specimens received in the wrong container.
Page last updated 11/01/2020 by MC. Please note that if printed, this information is only valid on the day of printing.