Get Semen Analysis Form

Filling out the Semen Analysis Form online is a crucial step in obtaining accurate results for your analysis. This guide will provide you with clear instructions for each section of the form, ensuring a smooth and straightforward process as you complete your submission.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access the Semen Analysis Form and open it in your selected editor.
2. Begin by entering your NHS number or hospital number in the designated field. This information is essential for identifying your records.
3. Provide the patient's surname followed by their first name, ensuring you use capital letters as instructed.
4. Fill in the date of birth (D.O.B) of the patient using the format specified in the form.
5. Complete the patient's address and post code accurately to ensure proper communication regarding the analysis results.
6. Specify the ward, department, surgery, or clinic where the analysis will be processed.
7. Enter the consultant's or GP's name associated with the referral.
8. Record the partner's surname and first name followed by their date of birth (D.O.B) as required.
9. Select the type of investigation being requested by ticking the appropriate box, either for post-vasectomy sample or semen analysis for infertility.
10. Indicate any risk of infection by ticking the box and providing specific details if applicable.
11. Complete the clinical details to give context to the sample you are providing.
12. The patient should fill out the section regarding the sample details, including the date and time of production.
13. Indicate whether this is the first sample being submitted by selecting 'Y' for yes or 'N' for no.
14. Answer if the whole sample was collected by marking 'Y' or 'N.'
15. Provide information on how many days it has been since the patient last had sex or masturbated.
16. Indicate whether any medication is being taken by marking 'Y' for yes or 'N' for no. If yes, specify the medication.
17. The patient must sign the form to confirm the accuracy of the provided information.
18. After completing the form, remember to save your changes, and consider downloading, printing, or sharing the completed form as necessary.

Complete your documents online today for a hassle-free experience!