Pathology Consumables Order Form
Practice Name
Practice Code
Practice address
 
Please allow up to one week for delivery.
Telephone Number
 
Description
Pack Size
Quantity
Serum Gel 5ml (gold)
50
Plain Serum 4ml (red)
50
Fluoride/Oxalate 2ml (grey/glucose)
50
EDTA 3ml (lavender)
50
Citrate 3.5 ml (blue/coagulation)
50
3.2ml Urine collection kits (Microalbumin)
100
Vacuette Safety Needles (21g green)
30
Vacuette Safety Needles (22g black)
30
Vacuette Holdex (luer-adapter)
100
Urine - plain universals 30 ml
50
Single liquid swabs (pink top)
50
Chlamydia/ GC swab for PCR
10
Male chlamydia container
10
Faecal pots
10
Histology pots 60 ml & forms
10
Seminal fluid pots and forms
5
Dermapaks (skin/nail scrapping packs)
5
Blood Sciences Pathology Bags (Green)
50
Microbiology Pathology Bags (Blue)
50
E-Requesting Carrier Forms and Bags
200
Zebra Printer sample/bag labels (GK420d printer)
1 (roll)
Zebra Printer sample/bag labels (QLN220mobile printer)
1(roll)
Specimen carrier bags
200
Other - please state:
Contact Information
Requisition Contact Telephone Number
01902 734544