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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

Prenatal Testing

Harmony- Provincially Funded High Risk Programs

• Harmony Prenatal Test Requisition for funded testing in BC - English only
• Harmony Prenatal Test Requisition for funded testing in MB following positive MSS - English only
• Harmony MOH Criteria for Eligibility Form
• Harmony Prenatal Test Requisition for MOH funded testing
• Harmony Instructions to Complete the Requisition

Prenatal Testing - Patient Pay

• Harmony & MaterniT Prenatal Test Requisition
• Harmony & MaterniT Payment Form
• Harmony DynaLife Third Party - Prenatal Test Requisition
• Harmony APL 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 AllergyRequisition- English only

Genetic Testing (MNG Laboratories)

• Genetic Test Requisition
• RNA Sequencing Requisition
• Whole Exome and Genome Sequencing Informed Consent
• Genetic Testing MOH Funding Information
• Genetic Testing Payment Form

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
• Histology Specimen Tracking Log - English Only
• Immunohistochemistry Requisition - English only
• Oral and Maxillofacial Pathology Requisition
• Prenatal Screening Requisition Mount Sinai Hospital - English only
• COVID-19 Antibody Test Panel Requisition English only

Manitoba

• Histopathology Requisition - English only
• Laboratory Requisition - English only
• Pharmacist Requisition - English only
• COVID-19 Antibody Test Panel Requisition - English only

Partner Supply Requisition

Quebec

• Partner Supply Requisition

Ontario

• Partner Supply Requisition
• Returned Goods Form - English Only

Test Catalog

Quebec

• Quebec-2021 Specimen Requirement Manual

MNG Laboratories (Genetic Testing)

• MNG Laboratories Genetic Testing Test List (English Only)