[ English | Bahasa Malaysia ] Today is 26th Sep 2022, 05:00 AM (Last updated: 21st Sep 2022)

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Diagnostic Service Forms

. Last Updated: 12 July 2022Hits: 131529


Biochemistry Unit, SDC

  1. IEM Request Form - version 6

Endocrine Unit, SDC

  1. Endocrine Request Form

Molecular Diagnostics Unit, SDC

  1.  Request Form for Molecular Diagnostics Services

Special Protein Unit, SDC

  1. Request Form For Special Protein Unit

Haematology Unit, CaRC

  1. aCGH Request & Consent Form
  2. Thalassaemia DNA Analysis Request Consent Form ( Bahasa Malaysia )
  3. Thalassaemia DNA Analysis Request Consent Form ( English )
  4. Lab Request - Cytogenetics
  5. Molecular Analysis for Leukaemia Request Form
  6. Chimerism Analysis Request Form
  7. Haemophilia B Request Form & Consent Form


Stomatology Unit, CaRC 

  1. Stomatology Request Form (Med 135)

  2. Request form for paraffin blocks & slides
  3. Request form for microscopic imaging

Autoimmune Unit, AIRC

  1. Autoimmune Request Form 


Primary Immunodeficiency Unit, AIRC

  1. PID Request Form 4.0


Transplantation Immunology Unit, AIRC

  1. AIRC_TI_Appendix 2 - Request Form for HLA Typing Test
  2. AIRC_TI_Appendix 3 - Request Form for HLA Typing Test (Disease Association)
  3. AIRC_TI_Appendix 4 - Request Form for HLA Crossmatch Test (Living Donor)
  4. AIRC_TI_Appendix 5 - Request Form for HLA Crossmatch Test (Deceased Donor)
  5. AIRC_TI_Appendix 6 - Request Form for HLA Antibody Test


Bacteriology Unit, IDRC

  1. Bacteriology Request Form 
  2. Leptospirosis Laboratory Request Form
  3. Brucellosis Laboratory Request Form
  4. Rickettsiosis Laboratory Request Form
  5. Tuberculosis Laboratory Request Form
  6. Mycology Request Form


Virology Unit, IDRC

  1. Acute Flaccid Paralysis (AFP) Case Investigation Form
  2. HIV NARL Form
  3. HIV PCR Paeds Form
  4. HIVDR (Drug Resistance Testing) Request Form
  5. Virology Test Request Form
  6. SARI Form

Parasitology Unit, IDRC

  1. Borang Permohonan Ujian Molekular Malaria
  2. Borang Daftar Kes Molekular Malaria
  3. Prosedur Permohonan Ujian Molekular Malaria




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