Symptomatic FIT Service

Public Health Wales Screening Laboratory

Telephone: 01443 235131

Email: phw.fit.symptomaticreferral@wales.nhs.uk

Web Referral Form

***Requests made using this form are still accepted*** 

This form is intended for requesting Faecal Immunochemical Tests by staff WITHOUT access to GPTR/WCP. If you DO have access to GPTR/WCP - we encourage you to use GPTR/WCP to submit this request. 

(Locations which fall within Aneurin Bevan, Cwm Taf or Hywel Dda Health board should NOT use this form - please refer to local guidance)

Please complete all the questions below for the referral to be processed:

Please check that the 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.