PARTICIPATE in a screening programme | Familial Hypercholesterolaemia Screening

FH kit (FH Auckland Labplus endorsed) $70.00 NZDSelf-paying (Kit + Analysis) $800.00 NZD includes GST
First Name *
Last Name *
Date of birth (DD/MM/YY) *
NHI number (if known) *
Ethnicity *
GP Name *
GP address *
Arcus cornealis at age <45 yrs *
First degree relative with known premature coronary and/or vascular disease, OR First degree relative with LDL cholesterol >95th Centile for age and sex *
First degree relative with tendon xanthomata and/or arcus cornealis OR Children <18yr with LDL >95th percentile for age & sex *
LDL Cholesterol *
Premature cerebral or peripheral vascular disease (men <55, women <60yr) *
Premature coronary artery disease (men <55, women <60yr) *
Tendon xanthomata *
Familial Hypercholesterolaemia Screening
Familial Hypercholesterolaemia Screening