Please ensure that you select the requisition matching each ordered test. Failure to complete the appropriate requisition may result in delayed processing and/or rejection of the sample.
The clinical indication for testing, sample type and clear identification of the authorizing provider must be indicated on the requisition to allow for appropriate and timely processing of the samples.
Laboratory requisitions
Standard Cytogenetic Requisition
For chromosome analysis, all FISH testing (including microarray follow up FISH testing) and RAD
Mandatory for all products of conception (POC), intrauterine fetal deaths (IUFD) and stillbirth samples referred for RAD/microarray testing. Also complete a Standard Cytogenetics Requisition. See shipping instructions.
Microarray and Microarray Follow Up Q-PCR Testing Requisition
For microarray and microarray follow up Q-PCR testing
Standard Molecular Requisition
For FMR1-related disorders, hemochromatosis, MCC, muscular dystrophy/atrophy testing, Prader-Willi/Angelman syndrome, thrombophilia, etc.
Hypertrophic Cardiomyopathy Requisition
For HCM panel.
Non-syndromic Cardiomyopathies Requisition
For ARVC and Pan-cardiomyopathy panels
Vascular Connective Tissue Disorders and TAAD Requisition
For Arterial Tortuosity, Loeys-Dietz syndrome, Marfan syndrome, TAAD panels
For products of conception samples that meet laboratory criteria. See shipping instructions.
Genome-wide Sequencing Ontario
For ordering genome-wide sequencing on patients who fulfill clinical criteria for testing. Visit the Genome-wide Sequencing Ontario website for more details.
Forms
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