• Results upload form

  • You are able to submit blood test results and pregnancy test results using this form. Only use this form if you have been asked to by the staff and are under regular care of this Clinic.

    Blood tests

    If you are submitting a blood test result, then you will need to have the results in a PDF format which states

    • the name of the patient
    • the date of birth 
    • the date the test was taken.

    Images and screen shots of blood test results which do not have all three pieces of information are not accepted.

    Pregnancy test

    If you are submitting a pregnancy test then you will need a photo of the pregnany test result, together with the manufacturer and serial number of the test (these can be found on the box).

    After submitting your results

    Once your submisions have been received, we will check the treatment plan you are on. If you are expected for a follow up consultation, then your results will be filed and reviewed when you attend for your consultation. 

    If you are unsure or need assistance in filling this form then please contact us on 0121 285 4540.

    Midland Skin Clinic

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  • I am a patient of the Clinic and I would like to submit:*
  • What is your date of birth?*
     - -
    2 digit day, 2 digit month, 4 digit year
    • Blood test results upload 
    • What was the date of the blood test?*
       - -
      2 digit day, 2 digit month, 4 digit year
    • Browse Files - PDF Only
      Drag and drop files here
      Choose a file
      Cancelof
    • Pregnancy test declaration and upload 
    • What was the date of the pregnancy test?*
       - -
      2 digit day, 2 digit month, 4 digit year
    • Browse Files - jpg, jpeg or png
      Drag and drop files here
      Choose a file
      Cancelof
    • Declaration 
    • Should be Empty: