Porphyrin request form

A porphyrin request form must accompany all samples sent to the laboratory. Request forms can be obtained by downloading and printing off and completing a form, completing a form electronically or by contacting the laboratory directly.

Every request for analysis accepted by the Scottish Cutaneous Porphyria Service will be considered as an agreement between the requestor and the SCPS, and we will assume that patient consent has been obtained in accordance with NHS Tayside policy. Requestors should be aware that, on occasion, patient results may be shared with other laboratories to assist with the interpretation of results and that family information may be relevant, e.g. when interpreting genetic examination results.

The porphyrin request form must be completed as fully and legibly as possible. The inclusion of relevant clinical details on the request form will help us to select the most efficient strategy for analysis of the sample and minimise sample turnaround times.

The porphyrin request form should be completed as shown below:

Source: PBUL009 06/12/2023 Issue:2 Review:1