Western Road Medical Centre

99 Western Road, Romford, Havering, RM1 3LS

Telephone: 01708 775300

nelondonicb.westernroad@nhs.net

We're open

Blood forms to download

Please note:

  1. The following forms may not contain all the relevant tests that you require – please do not use them unless a doctor has advised you to do so.
  2. The forms must be printed – you can’t present them on your phone.
  3. If more than one form applies to you then please print and fill out all the relevant forms.
  4. You need to fill them in by hand: family name, forename, address, date of birth (NHS number optional if all other details provided) and the date of the test.
  5.  Click here to arrange blood test

Blood form Diabetes review For patients with established diabetes – Please do not use for diagnosis

Cardiovascular disease risk monitoring Blood-form-CVS

Annual kidney test for people on new anticoagulants (NOAC/DOAC): e.g. rivaroxaban, edoxaban, apixaban

12 weekly test for people on DMARDS (e.g.methotrexate, azathioprine or ciclosporin)Blood-form-DMARDs

Annual kidney test for people on blood pressure medication

Annual kidney function test for patients taking long term oral NSAIDS (e.g. Naproxen, Ibuprofen, Nurofen, Meloxicam, Diclofenac, Indomethacin)

Annual Thyroid test for those taking thyroid medication

Anaemia test for people who have been using iron treatment

 

Opening Times

  • Monday
    08:00am to 06:30pm
    Extended hours appointments (pre-booked only) 18:30-19:00
  • Tuesday
    08:00am to 06:30pm
    Extended hours appointments (pre-booked only) 18:30-19:00
  • Wednesday
    08:00am to 06:30pm
    Extended hours appointments (pre-booked only) 18:30-19:00
  • Thursday
    08:00am to 06:30pm
    Extended hours appointments (pre-booked only) 18:30-19:00
  • Friday
    08:00am to 06:30pm
    Extended hours appointments (pre-booked only) 18:30-19:00
  • Saturday
    CLOSED
  • Sunday
    CLOSED
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