Andrology - More Info
Instructions for booking a detailed seminal analysis
- an appointment must be booked via your GP or Clinician
- please bring the sample at the date and time allocated to Specimen Reception at Good Hope Hospital Pathology Department
- remember to bring the completed form to the laboratory with you, stating time of collection, whether you have abstained from sexual intercourse/masturbation for 2-7 days and whether the entire sample was collected
- please hand directly to one of the laboratory staff. You will be asked to sign the form to confirm the sample is yours
- if you are unable to attend your appointment for whatever reason please telephone the laboratory or Fertility Department
Instructions for the collection of seminal fluid
- the sample should be collected after a minimum of 2 days and no more than 7 days abstinence prior to the appointment
- the sample should be collected directly into the sample pot by masturbation. Wash and dry hands and genitals before collection
- do not use a condom or withdrawal method for collection
- do not add anything to the pot before or after collection
- ensure the lid of the pot is fixed correctly and tightly to prevent leakage
- the sample must be kept at body temperature between the time the sample was taken and its arrival in the laboratory
- the sample must be delivered to the laboratory within 1 hour of collection
- write your full name, date of birth and date of production of the sample on the pot
Request forms
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Detail
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In-patient
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GP patient
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Registration number
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Write the registration number
In the box provided, including
the prefix.
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Leave blank.
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Surname/Family name
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Write the complete patient’s surname/family name in the box provided.
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Forename/Given name
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Write the complete patient’s forename in the box provided
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Date of Birth
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Write the patient’s Date of Birth in the box provided.
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NHS Number
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If known write the patient’s NHS number in the boxes provided.
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Gender
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Complete this box with M or F.
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Address
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Write the patient’s full address in the box provided if on the request form
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Post Code
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Write the patient’s full Post Code in the box provided.
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Hospital
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Write in the code or full name of the hospital the report is to be returned to.
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Leave blank
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Clinician
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Write in the full name of consultant.
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Write in the full name of the GP. If using a stamp ensure the details are clear.
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Location
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Write in the ward, unit or out-patient department.
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Write in the full address or known GP code.
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Category
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Section not on the request form.
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Circle if patient is NHS., Cat 2 or Private Patient.
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Copy to
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Section not on the request form.
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Write in the Dr’s name and location where a copy is required in the box provided.
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Clinical details
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Write all relevant details and medication.
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Date requested
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Write in the date in the box provided.
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Requesters signature
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Sign the form in the box provided.
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Contact/bleep number
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Write in bleep number
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Section not on the request form.
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Date and time collected
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Write in the date and time sample was collected in the box provided.
The time can be in 12 or 24 hours.
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Urgent
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Tick this box if the sample is urgent. Remember to put in a contact number.
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Sample collected by
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This must be signed by the person obtaining the sample.
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Specimen type
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Write in the sample type : blood, urine, etc
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Tests required
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Tick boxes of tests required. For tests not stated write clearly the name of the test in ‘Other Investigations’.
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