Completing the Requisition
Completing the Requisition
Correct, legible, complete clinical information is required on all requisitions. Missing or illegible patient and physician information is a significant contributor to delayed reporting or possible rejection.
The patient's full name (full first name and last name) AND at least one of the following unique identifiers are required:
- ULI Unique Lifetime Identifier)
- Personal Health Number (PHN)
- Personal Identification Number (e.g. Federal, Military, RCMP, Refugee, Immigration, Passport, etc.)
- Facility Assigned Number (e.g. Hospital, Clinic, Unit, Account, Accession)
Note:Date of Birth is not considered a unique identifier.
The following minimum demographic and test order information must be included on all requisitions.
Demographic and Test Order Information
Patient Name: Print patient's legal name legibly, LAST name first followed by FIRST name and MIDDLE initial. Please use legal first name.
Personal Health Number/Unique Identifier: Provide a unique identifier that can be traced directly back to the patient, specifically their ULI (Unique Lifetime Identifier), Personal Health Number (PHN), Personal Identification Number (e.g. Federal, Military, RCMP, Refugee, Immigration, Passport, etc.) or Facility Assigned Number. For patients who wish to maintain billing confidentiality and prevent a laboratory encounter from appearing on their Alberta Health Care statement, indicate "Suppression of Claim" here; DO NOT indicate patient's PHN.
Confidential Patient Information: In special circumstances, to maintain a higher level of confidentiality, patient identity may be protected by assigning a code name and number that is unique to the patient. You will need to maintain a record of the assigned patient code and number. The code and number you provide is the only identifying patient information that will appear on the laboratory report. DO NOT indicate the patient's PHN or other billing information.
Patient Address and Phone Number: Patient phone number is required for community patients. Patient address is not required for patients with a valid Alberta PHN. Addresses with postal code must be included for all out-of-province patients and in cases where patients are paying for their tests.
Chart Number: Enter the chart number, if applicable.
Gender & Date of Birth: Many reference ranges are determined by patient gender and/or age.
Tests Ordered: One requisition may be used to order multiple tests. Certain divisions/tests require specific requisitions.
Specimen Source & Patient History: Indicate specific source and/or site plus patient history.
Date & Time of Collection: Date and time must be recorded as well as the name or initials of the collector.
Specimen Priority: Indicate if any tests are required stat.
Referring (Ordering) Physician: Indicate the name and location of the ordering physician. Community physicians are provided with a stamp. For further information on the importance of the stamp or how to request new or modified stamps, see the Information for Physician and Healthcare Professionals section: Ordering Information When a stamp is not available for use, please provide the physician's first and last name and address for report delivery. If available, also include the physician's client and provider number.
Copy to Physician: When requesting additional report copies please provide the first and last name and location of the 'copy to' physician.
Pathology. Cytology. Genetics
- Exact site (source/type) (e.g. laterality, lobes, quadrants, etc.), organ of origin and procedure type
- Relevant clinical history (if applicable)
- Devitalization and tissue fixation time
- Collection date and time
Ensure the Microbiology Requisition includes all relevant patient history, i.e. travel, suspected organisms/infection/diagnosis, if the patient is immunosuppressed or neutropenic, and list all antibiotics the patient is currently taking.
A completed history form is required for specific test requests as per Zone requirements (e.g. Calgary - malaria, stool O&P).
Use of a Transfusion Medicine requisition is required
For additional information on test requests and requisition minimum requirements refer to Acceptance of Laboratory Samples & Test Requests Policy and Appendix A.
- Complete the clinical information, transfusion history, transfusion/surgery location date and time. This information is required to ensure appropriate blood products are available on site in time for transfusion.