If you are unable to find a requested test on this order form, please check the alphabetical A-1a Pathology Doctor Orders (MH07910) before handwriting tests on a 0-4 Miscellaneous Request form.
Also: Please use MH06111 for all Immunopathology orders and MH0811 for all Microbiology requests.
As always, please note the following points that are required for all requisitions:
1. Stamp or legibly print the patient's hospital number, name (last, first, middle initial) and birth date. Use of the IPR bar-coded label is acceptable.
2. Print the nursing station or clinic
3. Record the date and time the sample was collected or drawn
4. Complete both the physician's name and CLP#. CLP# alone is not acceptable.
5. Mark each test requested individually. Do not draw a line through multiple boxes (see example below of an appropriate and an inappropriate order).
Please contact Dr. John Kemp (384 9611) or Dr. Peter Kaboli (384-8512) with concerns.
See the illustration below for appropriate requisition completion.