Laboratory Requisitions

A

Adverse/Reaction Event Form [PDF]

B

Blood Transfusion Service Request Form[PDF]

C

CPOE Pathology Orders Form[PDF]

Cytology and HPV Request Form [PDF]

F

Flow Cytometry Request Form [PDF]

H

Health PEI Provincial Lab Services Practitioner Change Form [PDF]

I

INR Point of Care (POC) Confirmation Form [PDF]

IVIG - Dermatology (Adult and Pediatric) Request Form [PDF]

IVIG - Emergency Release Form[PDF]

IVIG - Hematology (Adult) Request Form[PDF]

IVIG - Hematology (Pediatric) Request Form[PDF]

IVIG - Immunology (Adult and Pediatric) Request Form[PDF]

IVIG - Infectious Disease (Adult and Pediatric) Request Form[PDF]

IVIG - Neurology (Adult and Pediatric) Request Form [PDF]

IVIG - Rheumatology (Adult and Pediatric) Request Form [PDF]

IVIG - Solid Organ Transplant Request For[PDF]

IVIG - Subcutaneous Immunoglobulin (SCIG) Request Form[PDF]

L

Laboratory Blood Test Request Form[PDF]

M

Microbiology Blood Requisition Form (serology)[PDF]

Microbiology Request Form[PDF]

N

 

P

Physician/NP Field on Laboratory Requisitions [PDF]

Post-Mortem Test Request Form [PDF]

R

Reaction/Adverse Event Form[PDF]

Request for Hemlibra, Panhematin or Glassia [PDF]

S

Serum Allergy Test Request Form[PDF]

Storage Requirements for Hematology Samples Prior/During Transport to QEH Laboratory [PDF]

Surgical Pathology and Bone Marrow Request Form[PDF]

Surgical Pathology Frozen Section:  Intra-Operative Consultation Report [PDF]

U

Urine, Body Fluids and CSF Test Request Form[PDF]

Urine Drug Screen Confirmatory Testing Form[PDF]

V

 

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