FORM FOR REPORTING CASES TO TOXBASE
 
Please complete the form below to tell us about your patient:
 
 
 
Sex of patient:


 
 
 
 
Anything else taken:
 
Features of poisoning:
 
Management and additional comments:
 
 
 
 
 
 
 
 
Alternatively you can print this form and post it FREEPOST to us at
Freepost RRKS-LJZH-JYRB,
NPIS Edinburgh,
Royal Infirmary of Edinburgh,
Edinburgh, EH16 4SA
or
fax it on 0131 242 1387.