<!-- BEGIN [% component.name %] -->
<div class="request_form">
<div align="center">
<img src='/images/outreach_header.png' alt="" />
</div>
<p class="address">
[% c.cfg('settings').lab_name_abbreviation %],
[% c.cfg('settings').service_address %]
Telephone: [% c.cfg('settings').service_telno %] ~ FAX: 0113 206 7883
</p>
<h2>Outreach monitoring service for haematological disorders</h2>
<p>Enclosed is a pack for monitoring your disorder. Please read the instructions
below before you continue. It is important that you <b><u>do not seal the
pack</u></b> until you have been to the general practice. </p>
<ul class="cover">
<li>
Please make an appointment to see the nurse or phlebotomist at your
general practice. The appointment should be on a Monday, Tuesday,
Wednesday. <b>No appointments should be made on a Friday</b> - the
samples will be too old by the time they get to us and so it is better
to wait for an appointment at a later date.
</li>
<li>
Please complete the questionnaire before you go to the general
practice. If you have any problems completing the questionnaire,
please contact us on the telephone number or email address below.
</li>
<li>
When you go to the general practice, please <b>take this letter along
with all the other paperwork and the blue pack</b>. The nurse or
phlebotomist will take the blood samples. Please give them with your
completed questionnaire to put in the pack before sealing it.
</li>
</ul>
<p>Information for the nurse/phlebotomist:</p>
<ul class="cover">
<li>
If the blood tubes in the pack are different to the tubes routinely
used at your practice, please discard them and use your own tubes �
1 x EDTA (e.g. full blood count) and 2 x serum (e.g. U&E).
</li>
<li>
Please ensure that the pack contains: blood samples, HMDS request
form, biochemistry and immunology request forms, completed symptom
questionnaire and EQ-5D ("assessing your current health state").
</li>
<li>
Once the pack is sealed and the address label is put in place, it is
safe to send in the post like a normal letter � there is no need to
put it in an envelope and the <b>postage has already been paid</b> as
stated on the address sticker. <b>The practice nurse or phlebotomist
should send the pack with the rest of the practice mail</b>. Please
contact us if there might be any delay in posting as the pack needs
to be returned as soon as possible after the samples have been taken.
</li>
</ul>
<p>If you have any problems please contact HMDS on 0113 2067851 and ask to
speak to somebody about Outreach monitoring or email
victoria.martin@leedsth.nhs.uk</p>
</div>
<!-- END [% component.name %] -->