Print a Form

It’s fast and easy to find the test requisition, supply order form or insurance claim form you need. All test requisitions and supply order forms are listed by province or nationally. Simply click on the link to access and print the form you need.

Test Requisitions

National

• Molecular Diagnostics - Hematology Requisition

Harmony

• Harmony Prenatal Test Requisition
• Harmony Prenatal Test Requisition for funded testing in BC - English only
• Harmony Instructions to Complete the Requisition
• Harmony MOH Criteria for Eligibility Form 
• Harmony Prenatal Test Requisition for MOH funded testing 
• Harmony Payment Authorization Form
• Harmony DynaLife Third Party - Prenatal Test Requisition 
• Harmony CLS Third Party - Prenatal Test Requisition 

Color

• Color Test Requisition
• Color Informed Consent for Genetic Testing
• Color Health History Form
• Color Payment Authorization Form

Genecept Assay

• Genecept Assay Requisition
• Genecept Assay Payment Authorization Form 

Allergy Testing

• ​Allergy Requisition
• Food Component Allergy Requisition- English only

Quebec

• General Test Requisition
• Cytology Requisition
• Oral and Maxillofacial Pathology Requisition

Ontario 

• Ministry of Health Requisition - English only
• Public Health General Test Requisition - English only
• CEA Assay Requisition- Cancer Care Ontario - English only
• CEA Authorization Form- English only
• CEA Authorization Form- Ottawa General - English only
• Cytology Requisition - English only  
• Dermatology Requisition - English only
• Flow Cytometry Requisition - English only    
• Hemochromatosis- CHEO - English only
• Hemochromatosis- Kingston General - English only
• Hemochromatosis- London Health Sciences Centre - English only
• Histology Requisition- English only  
• Immunohistochemistry Requisition - English only
• Oral and Maxillofacial Pathology Requisition
• Prenatal Screening Requisition – Mount Sinai Hospital - English only

Manitoba 

• Histopathology Requisition - English only
• Laboratory Requisition - English only
• Pharmacist Requisition - English only

Partner Supply Requisition

National  

Quebec

• Partner Supply Requisition

Ontario

• Partner Supply Requisition

Manitoba

 

Test Catalog

Quebec

• Quebec-2019 Specimen Requirement Manual