Symptomatic FIT request form.
Please complete all fields - ensuring all information you enter on this form is correct. If the patient details do not match our records, we may not be able to accept the referral/sample.
Once you submit a request - a testing kit will be sent to the address as entered on the request form. (if you wish for the test to be sent to an address other than the patients home address, please enter this into the form)
If you have any questions, please contact [email protected].