Laboratory Requisition - Interior Health Authority 2026

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The document is a laboratory requisition form that outlines the necessary information and guidelines for ordering various medical tests. It includes sections for patient details, physician information, test selections across different categories (hematology, microbiology, chemistry, etc.), and instructions for specimen collection. The form emphasizes the importance of completing shaded fields to prevent delays and provides contact information for multiple laboratories along with patient instructions regarding fasting and test preparation.

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Click ‘Get Form’ to open the Laboratory Requisition in the editor.
Begin by filling out the 'Ordering Physician' section, including your address and MSP practitioner number. This information is crucial for processing.
Next, complete the 'Patient' section. Enter the patient's surname, first name, date of birth (DOB), sex, and PHN number. Ensure all shaded fields are filled to avoid delays.
Indicate if this is a STAT order by providing a contact telephone number. This helps prioritize urgent requests.
Fill in the 'Diagnosis' and 'Current Medications' sections accurately to inform laboratory staff of any relevant medical history.
Select the required tests from the various categories such as Hematology, Microbiology, and Chemistry. Make sure to check any special instructions related to fasting or specific conditions.
Finally, sign and date the form at the bottom before submitting it to ensure it is valid for processing.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (86 Votes)
2011	4.4 Satisfied (48 Votes)

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How can I eSign my interior health mri requisition from Gmail?

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How do you fill out how to fill out a lab requisition form on iOS?

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Which information is required on a lab requisition?

The laboratory test request must provide the following information: Ordering providers full name, address, phone number, and provider signature. Patients name and date of birth.

Who is authorized to place an order for a laboratory test?

The requisition will display the patients demographics and all information that was documented on the order. Once processed, this requisition will be sent electronically to the lab. Remember, the patient must be admitted, and a Lab Order is required before a requisition can be created.

What are the required information on a requisition form?

Requisition forms typically include line items such as the: Name of the person or company making the request. Date of the request, items requested, the delivery date. Delivery location and contact information.

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What are three things commonly required on the requisition form?

To request the purchase of goods or services: A requisition form is used by your company to request the purchase of goods or services from a vendor. The form typically includes information about your requested goods or services, the quantity needed, and the estimated cost.

What is a laboratory requisition?

A Test Requisition Form, also known as a lab test requisition form, is a document that healthcare providers use to request specific laboratory tests for patients. These forms are pivotal in the medical testing process.

Is a lab requisition the same as a lab order?

Are appointments required? Appointments are not required but may help reduce your patients wait time.

What is required on a laboratory requisition?

The physician who treats a patient must order all diagnostic x-rays, diagnostic laboratory tests, and other diagnostic tests for a specific medical problem. The physician uses test results to manage the patients specific medical problem and may provide a consultation.

Laboratory Requisition - Interior Health Authority 2026

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Got questions?

How can I eSign my interior health mri requisition from Gmail?

How do you fill out how to fill out a lab requisition form on iOS?

Which information is required on a lab requisition?

Who is authorized to place an order for a laboratory test?

What are the required information on a requisition form?

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What are three things commonly required on the requisition form?

What is a laboratory requisition?

Is a lab requisition the same as a lab order?

What is required on a laboratory requisition?

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