Microbiology Request Form - Health PEIStaff Resource Centre 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's Date of Birth (DOB) in the specified format (MMM-DD-YYYY). This is crucial for accurate identification.
3. Fill in the Medical Record Number (MRN) and select the patient's sex. Ensure this information is correct as it links to patient records.
4. Indicate payment responsibility by checking the appropriate box, such as WCB, DVA, or Self Pay options.
5. Provide relevant clinical information in the designated section. This helps microbiologists understand the context of the request.
6. Select any specific tests required from the list provided, ensuring you specify sites where necessary. For example, if requesting a throat swab, indicate 'Throat' under 'Other'.
7. Finally, review all entered information for accuracy before submitting your form through our platform.

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