CONSUMABLES ORDER FORM CERVICAL CYTOLOGY, HISTOLOGY & HPV TESTING
(a) Slide container
(b) Glass slides
(g) Cytology Fixative Spray (h) Disposable Specula
(c) Endocervical Brush
(d) Spatula - Plastic
(i) Thin Prep Sampling Vial
(j) Histology Containers
(e) C ervical Sampler Broom Type
(f) Cervix Brush Combi
CHLAMYDIA TESTING
A (k) U ri SWAB (Chlamydia Urine)
(l) Flocked Swab (Chlamydia)
(m) Chlamydia & Pap Test Pack
B
C
Chlamydia Posters
Contains slide & slide container, cervical sampler and flocked swab.
TRANSPORTATION AND MAILING SUPPLIES PO Box 752 Swan178 Carlt on ston Phon St, South e: 03 9250 Carlton VIC 3053 0300 VIC 3053
VICTOR Reply IAN CYT OLOGY Paid CARLTO 178 SERVIC N SOU E TH VIC 3053
UN33 73 BIOLOG
ICAL
SUBSTA
NCE
S – CAT
EGORY
(n) Specimen Bag
(o) Reply Paid Envelopes (post only)
(p) Tube Mailer (post only)
(q) Pot Mailer (post only)
B
(r) Reply Paid Satchel (post only)
For detailed mailing instructions go to http://www.vcs.org.au/practices/mailing.html MANUAL REQUEST FORMS (Provide details to be pre-printed on Manual Request Forms)
PO Box 752 Swa 178 Carl Phone: nston ton South VIC 3053 03 9250St, Carl 0300 ton VIC 3053
VCS PRACTICE NUMBER:
PHONE: VICTO RIAN Reply CYTO LOGY Paid CARL 178 SERV TON ICE SOUT H VIC 3053
NAME: ADDRESS:
UN33 73 BIOLO
GICAL SU
BSTA
POSTCODE:
NCES
– CA TEGO
RY B