Personalized application forms

The AZJP Clinical Laboratory can provide personalized application forms, if requested.

The following information is required as a minimum on the application form:

• Details of the requesting physician:
  
  Name, first name, address, NIHDI accreditation number and signature.
• Information about the patient:
  
  Name, first name, address, date of birth, gender, National Register number.
  
  Clinical data, as requested on the application form
• Administrative data:
  
  Date of sample collection
  
  Each test MUST be ticked individually.