Requisition PDFs

All Labs Biochemistry Biochemistry & Genetics Immunology Microbiology Cytology Genomics Hematology Pathology Transfusion Medicine

ACTH (Cosyntropin) STIMULATION (regular dose)

Arginine Stimulation

Cadham HIV Requisition

Cervical Cytology Request Form

Cervical Cytology Request Form SBH/Bethesda

Clonidine Stimulation

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)

Insulin Stimulation

L-Dopa Propanolol Stimulation

Miscellaneous Test Report (Rural) F100-20-1100 V08

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

SBH Biochemistry Timed Collection Booking Fax Form

SBH Test Add-On Form (Biochem, Hem, Imm) (F100-10-53E)

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)

_SH Adrenal Vein Sampling Requisition (R250-10-59)

_SH Anti-SARS-CoV-2 Antibody Detection Requisition (R250-10-96)

_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 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 Endocrinologist Test Request (R250-10-97)

_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 Blood Components and Products (F160-INV-33)

_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)