1. Patient information:

• Patient’s full legal name
• Unique lifetime identifier, personal health number or acceptable alternate identifier
• Date of birth
• Gender
• Address and postal code
• Telephone number

2. Physician information:

• Physician’s full name
• Phone number
• Physician code
• Ordering address
• Report location code – to ensure the results are directed to the correct location
• Complete full name (first and last) and address of any other health care professional who requires a copy of the report.

3. Specimen source
4. Date and time of collection
5. Clinical information (eg. diagnosis, medications, etc.)
6. All tests required

 A complete requisition must accompany each specimen type.

Incomplete requsitions may cause a delay in testing and/or the specimen not being processed. The laboratory will make every reasonable attempt to contact the physician if critical information is missing.

“Copy to” Information

In accordance with the Health Information Act, DynaLIFE_Dx will only send copies of the report to other health care professionals if the full name (first and last) and address of the health care professional is provided in the "copy to" section of the original requisition. DynaLIFE_Dx will not provide copies to other health care professionals if required information is missing from the requisition or if a final report has already been issued. If a physician wants to provide the report to other health care professionals, it is his/her responsibility to do so in accordance with the Health Information Act.

Clinical Information

Providing additional relevant information is very important in alerting the laboratory of the need for special handling or specimen work-up.