Requisitions

DynaLIFE Dx

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Requisitions

Edmonton zone

General requisition-Edmonton
Microbiology requisition-Edmonton
Cytology/Tissue Pathology-Edmonton
Transfusion Medicine - Edm
Please use Canadian Blood Services requisition if transfusion will occur at Cross Cancer Institute.

Back of requisition- Edmonton
Including list of Patient Care Centre addresses and condensed fasting instructions.

Complete Patient Care Centre Information

Complete Patient Instructions

Outside Edmonton Zone - Specimens sent to DynaLIFE Dx

General requisition- DynaLIFE_Dx
Microbiology requisition-DynaLIFE_Dx
Cytology/Tissue Pathology-DynaLIFE_Dx
Urea breath test requisition

Back of requsitions- DynaLIFE_Dx
Including list of Patient Care Centre addresses and condensed fasting instructions.

Complete Patient Care Centre Information.

Complete Patient Instructions

Speciality Requisitions - AHS Edmonton zone

Chemistry Specialty Requisition- AHS Edmonton
Hematology Specialty Requisition- AHS Edmonton
Maternal Prenatal Screen Requisition-AHS Edmonton
Molecular Diagnostic Requisition- AHS Edmonton
Molecular Pathology Requisition- AHS Edmonton
Semen Analysis Requisition- AHS Edmonton

Provincial Laboratory Requisitions - North

Culture and Serology Requisition- Provincial Laboratory North
Serology Requisition- Provincial Laboratory North

Provincial Prenatal Program Requisitions

Prenatal Testing - Initial Screen for Pregnant Women

2-part requisition can be ordered from:
Government of Alberta on-line forms and publications ordering
(Use form HS0001-133 (Prenatal testing - Initial Screening for Pregnant Women)

Prenatal Testing - Universal Syphilis Retesting
Perinatal Follow-up Testing for Red Blood Cell Serology

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