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)
5. They can be used at these clinics

Annual Diabetic check For patients with established diabetes – Please do not use for diagnosis

Annual Test for patients with high cardiovascular risk OR taking medication for cholesterol OR those with established Cardiovascular disease (e.g. previous heart attack, angina, stroke, TIA, peripheral vascular disease)

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)

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 levothyroxine

Anaemia test for people who have been using iron treatment