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Requestors Name *
Requestor Job Title *
Location / Ward  *
Contact / Extension Number *
Quantity Required
MRSA Dual Liquid Swabs
Single Liquid Swabs
Paired Blood Cultures
Paediatric Blood Cultures
Faeces Pots
Viral Swabs (Remel red top)
Genital HSV swab for PCR (blue top)
Chlamydia / GC swabs for PCR
Cystic Plates (Paeds only)
Ring Microbiology on 8255
Crystal Violet
Neutral Red
Microscope Slides
Gram stain control slides
In order to provide an efficient service the following will apply:
Order to be submitted during
Collection during
Zone A
Week 4 of month
(eg. April)
Week 1 of following month
(eg. May)
Zone B
Week 1 of month
Week 2
Zone C
Week 2 of month
Week 3
Zone D
Week 3 of month
Week 4

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