Test Requisitions
Consistent with O. Reg. 671/92 of the French Language Services Act, laboratory testing requisition forms linked on this page are only available in English because they are scientific or technical in nature and are for use only by qualified health care providers and not by members of the public.
General
Novel Pathogens
- Coronavirus Disease 2019 (COVID-19) – PCR Test Requisition
- Refer to the Coronavirus Disease 2019 (COVID-19) – PCR Test Information Sheet for Specimen Collection, Testing, and Reporting Information
- Refer to our Fact Sheet - Completing the COVID-19 Virus Test Requisition
Bacteriology
Environmental Microbiology
- Bacteriological Analysis of Drinking Water for Private Citizen, Single Household Only
- Bacteriological Analysis of Water - Multiple Sample Requisition for Official Agencies
- Environmental Microbiology Investigation Requisition
- Food Bacteriology Requisition Form
- Potability of Water Release Form
Virology
- HCV/HBV Viral Load, Genotyping, and Drug Resistance Testing Requisition
- HIV Genotyping Resistance and HLA-B*57:01 Abacavir Hypersensitivity Testing Requisition
- HIV Serology and PCR Test Requisition
- HIV Viral Load Monitoring Requisition Form
- Newborn CMV PCR Test Requisition
- Prenatal Screening Requisition
Mycobacteriology
Outbreak
Surveillance
- Surveillance Form for Tick Identification (as of August 2021 – see Labstract)
Suspicious Packages
Public Health Ontario Notice of Collection
OAHPP collection of personal health information on this form is collected under the authority of the Personal Health Information Protection Act, s.36 (1)(c)(iii). These forms generally contain patient demographic and registration information (e.g. name, address, date of birth, health number), diagnosis, the provider's name and contact information, test requested and reason for testing.
If you have questions about the collection of this personal health information, please contact:
Manager
Public Health Ontario
Customer Service Centre – Laboratory Services
661 University Avenue, Suite 1701
Toronto, ON M5G 1M1
Phone: 416-235-6556
Toll free: 1-877-604-4567
Protecting Your Information: If you are using this online service, it is important to ensure that you do not leave the computer unattended while accessing the service. Before leaving the computer, it is also important that you fully exit the application, clear your browser's cache and close down your browser. This will ensure that no one else can access any personal health information you may have entered.
This page provides a list of test requisition forms for requesting laboratory tests from Public Health Ontario. This information is for use by qualified health care providers only.
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