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Requisition PDFs
All Labs
Biochemistry
Biochemistry & Genetics
Immunology
Microbiology
Cytology
Genomics
Hematology
Pathology
Transfusion Medicine
ACTH (Cosyntropin) STIMULATION (regular dose)
Arginine Stimulation
Cadham
Cadham HIV Requisition
Cervical Cytology Request Form
Cervical Cytology Request Form SBH/Bethesda
Cincinnati Children's Hospital Immunology Test Requisition
Cincinnati Children's Hospital Molecular Genetics Test Requisition
Cirion Lab Requisition (supplied with kit)
Clonidine Stimulation
FISH Panel - Mayo Clinic
Flow Cytometry Requisition (Calgary) FC3200
GD Specialized Diagnostics Requisition
Gastrin Secretin Stimulation Test
Glucagon Stimulation
Glucose GH Suppression
GnRH Stimulation Female
GnRH Stimulation Male
Growth Hormone Sleep Study
Hemostatsis Consult F140-80-48A
I-Stat Requisition - Report (F110-10-04A V05)
IERHA Downtime Request and Report (R250-10-15)
IERHA Urinalysis Request and Report (R250-10-14)
IV Busulfex Pharmacokinetics Requisition
Insulin Stimulation
L-Dopa Propanolol Stimulation
LabPMM - Molecular
Mayo Hematopathology/ Cytogenetics Test Requsition
Miscellaneous Test Report (Rural) F100-20-1100 V08
Mitogen Advanced Diagnostics Laboratory - Autoantibody Test Req
Molecular Genetic BC Cancer/PHSA Labs Requisition
Mount Sinai Cytogenetics Requisition and Consent Form
Neuroimmunology Labs Requisition
Pathology Lab Test Requisition (Form #BRH 012) - Westman Lab
Pathology Services HSC Laboratory Requisition (80993)
Pathology Services Histology Breast Requisition - Excision (7102-8999-9)
Pathology Services Histology Core Biopsies - Breast Requisition
Please see current example of the CBS Requisition required in LIM entry's Comment Section below.
Rasburicase Protocol - Uric Acid
Repeat Diagnostics - Molecular
Request for Release of Blood Components and Products (F160-INV-33)
Retrovirus Nucleic Acid Testing (CPL form MG5126)
SBH Biochemistry Timed Collection Booking Fax Form
SBH Test Add-On Form (Biochem, Hem, Imm) (F100-10-53E)
Saskatchewan Cytogenetic Requisition
SickKids Microarray Requisition
Sudbury Cytogenetic Requisition
Sudbury Microarray Requisition
TRH Stimulation (Combined)
TRH/GnRH Stimulation Female
TRH/GnRH Stimulation Male
TRH/Prolactin Stimulation
TRH/TSH Stimulation
Triple Test Female
Triple Test Male
Use 4-Part CBS Transfusion Reaction Investigation CM105 Form (DO NOT PRINT Online Form)
VIPIT McMaster Univeristy Platelet Immunology Lab
Versiti Platelet and Neutrophil Immunology Lab Requisition (Formerly BloodCenter of WI)
Washington University Neuromuscular Clinical Laboratory - Antibody Testing Req
_SH Adrenal Vein Sampling Requisition (R250-10-59)
_SH Approval for Test Referral Biochemistry (F260-11-02)
_SH Approval for Test Referral Immunology and Hematology F150-100-100
_SH Biochemical Genetics Laboratory Requisition (R250-10-69)
_SH Biochemistry Hematology Requisition (R250-10-92)
_SH Body Fluid Requisition (R250-10-53)
_SH Bone Marrow Requisition (R250-10-86)
_SH Bone Marrow Review / Consult Request (F140-50-22)
_SH CM077 Fax Notification (F160-INV-32)
_SH Cytogenetics & FISH - Prenatal Requisition (R250-10-73)
_SH Cytogenetics & FISH Hematology/Oncology Requistion (R250-10-72)
_SH Cytogenetics & FISH Tissues Requisition (R250-10-74)
_SH Cytogenetics & FISH – Constitutional requisition (R250-10-71)
_SH Cytogentics Oncology Requisition (R250-10-72)
_SH Dauphin Downtime Hematology Requisition F100-120-0105
_SH Drug Screen Consultation Requisition (R250-10-24)
_SH Emergency Urgent Care Laboratory Requisition (R250-10-88)
_SH Endocrinology (General) Primary Care Requisition (R250-10-76)
_SH Endocrinology (Specialist) Requisition (R250-10-77)
_SH Flow Cytometry Laboratory Requisition (R250-10-82)
_SH HIT Screen - Heparin Induced Thrombocytopenia Screening Requisition (R250-10-81)
_SH HSC Biochemistry Potassium (Hyperkalemia) Test Requisition (R250-10-01)
_SH HSC Molecular Diagnostic Hereditary Cancer Test Requisition (R250-10-10)
_SH HSC Molecular Diagnostic Lab Test Requisition (R250-10-09)
_SH HSC Molecular Hematopathology (R250-10-29)
_SH Haemostasis Test Requisition (R250-10-12)
_SH Hemoglobinopathy Investigation Requisition (R250-10-78)
_SH Hereditary Cancer Molecular Requisition (R250-10-10)
_SH Hospital Biochemistry Hematology Non Winnipeg Brandon (R250-10-91)
_SH Immunology Autoimmune Laboratory Requisition (R250-10-85)
_SH Immunology Test Requisition (R250-10-21)
_SH KR001 Molecular Pathology Requisition (R250-10-61)
_SH Microbiology - Provincial Requisition (R250-10-06)
_SH Molecular Diagnostic Lab (R250-10-09)
_SH Non-Gynaecological Cytology Requisition - HSC (2 pages) (R250-10-30)
_SH Non-Gynaecological Cytology Requisition - SBH (2 pages) (R250-10-31)
_SH Non-Gynaecological Cytology Requisition - SBH/Bethesda (R250-10-32)
_SH Non-Gynaecological Cytology Requisition - WL (R250-10-34)
_SH Order of Draw Chart for Phlebotomy (Poster F100-10-20)
_SH Pathology Services Placental Examination Requisition (R250-10-38)
_SH Pathology Services SBH Laboratory Requisition (R250-10-39)
_SH Pathology Services SBH/Bethesda Laboratory Requisition (R250-10-40)
_SH Peritoneal Dialysis - Kt/V Requisition (R250-10-84)
_SH Request for Prothrombin Complex Concentrates (PCC) (F160-INV-16B)
_SH Request for Release of Red Blood Cells (F160-INV-34)
_SH Transplant Immunology Test Requisition/Report (R250-10-63)
_SH Urine Testing Requisition (R250-10-95)
_SH Vitamin D (25-Hydroxy) Requisition (R250-10-75)
_SH Winnipeg Brandon Biochemistry Hematology Requisition (R250-10-94)
_SH Winnipeg Brandon Hospital Biochemistry Hematology Requisition (R250-10-93)