[% entry.first_name | ucfirst %] [% entry.last_name | upper %] :: [% INCLUDE site/nhs_number.tt nhs_number = entry.nhs_number %] :: [% entry.dob.strftime('%d.%b.%Y') %]
Please complete this form and return it with the blood samples. In case of any problems with samples or symptoms, please contact or Carol Reid or Andy Rawstron on [% c.cfg('settings').service_telno %] andy.rawstron@nhs.net
[% # entry.questionnaire; INCLUDE "worklist/local/outreach/${entry.questionnaire}_questionnaire.tt"; %]Other common symptoms:
Infections: Your blood disorder can make you more susceptible to infections. Please contact your GP at the first signs of an infections as they will be aware that you need prompt access to antibiotic or antiviral drugs.
Fatigue or tiredness: This is a common problem and is often unrelated to your blood disorder. The blood tests that we do can detect some causes of fatigue. If we find anything, we will let you know whether this should be followed up at your local surgery or at the haematology clinic.
If you have any other symptoms that you think may be related to the blood disorder, please record them overleaf. You should also discuss it with your GP if it is a persistent problem that is concerning you.
Please also complete the general health questionnaire