Virology Diagnostic Request Forms

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The above files are in Portable Document Format (PDF). If your web browser does not support PDF vierwing, try Adobe Acrobat Reader.

Consent Forms

The NVRL require the following on consent forms:

  1. Headed paper
  2. Patient name in block capitals
  3. Patient signature
  4. Patient date of birth
  5. Laboratory Test(s)/results to be released
  6. Doctor’s name in block capitals
  7. Doctor’s signature
  8. Address of Clinic/Hospital
  9. Date

A template can be downloaded here.