1. • Please use the latest form. 

   • Recent FBC (within 3 months) and a copy of Hb analysis report must be attached. The attached FBC result must be labelled with 2 identifiers (name and IC/passport number).

   • All paediatrics (<12 y.o) sample to be referred to IMR, MUST be accompanied by both parents' FBC and Hb analysis results. Parents' samples are not required.

   • Consent form must be filled and signed by the patient or parents/guardian if the patient is less than 18 years old.

   • The request and consent form must be signed by medical officer.

1. • Please use the latest form. 

   • All carrier screening must be accompanied by an index sample with separate request form.

   • A copy of the index and relative genetic test result (if available).

   • Family tree.

   • Consent form must be filled and signed by the patient or parents/guardian if the patient is less than 18 years old.

   • The request and consent form must be signed by medical officer.

1. • It is MANDATORY to fill in the form with relevant clinical history and drug history (i.e. anticoagulant usage/ factor replacement therapy including date and time of last dose given).

   • Patient on anticoagulant or certain drugs should be discontinued as below:

     1. Warfarin 2 weeks

     2. Un-fractionated heparin (UFH) 24 hours

     3. Low molecular weight heparin (e.g; clexane) 12-24 hours

     4. Direct oral anticoagulant (e.g; dabigatran, apixaban) 72 hours

     5. Emicizumab 6 months (Further reading)

   • For thrombophilia testing, please use this guideline

     1. Testing should be delayed until at least 6 weeks after the acute event.

     2. Arterial thrombotic event is not an indication for heritable thrombophilia study.

     3. Testing for heritable thrombophilia study is not recommended in patient with CVC-related venous thrombosis.

1. • Please use the latest form. 

   • Recent FBC (within 3 months) and a copy of Hb analysis report must be attached. The attached FBC result must be labelled with 2 identifiers (name and IC/passport number).

   • Consent form must be filled and signed by the patient or parents/guardian if the patient is less than 18 years old.

   • The request and consent form must be signed by medical officer.

Indication: 

1. FBP showed RBC morphology features of SAO in:

   • Neonatal anaemia/hyperbilirubinemia

   • Severe anaemia in adult and hemolysis picture

   • Both husband and wife with history of hydrop fetalis

   • Distal renal tubular acidosis

2. Suspected homozygous SAO

3. TDT and non-TDT thalassemia patient with co-inheritance SAO