General Test Requisition Form for Public Health Ontario
This document is a comprehensive form that health care providers in Ontario must complete for each specimen submitted for testing. It details the patient information, submission details, and the specific tests requested. Proper completion ensures timely and accurate processing of laboratory tests.
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How do I fill this out?
Begin by completing all the required sections of the form accurately. Ensure that you provide all necessary patient, submitter, and specimen information. Make sure the test(s) requested are clearly listed and that all relevant fields are filled out to avoid delays in processing.
How to fill out the General Test Requisition Form for Public Health Ontario?
1
Complete all required sections for each specimen submitted.
2
Fill in patient and submitter information accurately.
3
Specify the patient setting and testing indications/criteria.
4
Provide detailed signs, symptoms, exposure, and travel history.
5
List the requested tests clearly and ensure all fields are filled.
Who needs the General Test Requisition Form for Public Health Ontario?
1
Health care providers who need to submit specimens for testing.
2
Laboratories requiring proper documentation for specimen submissions.
3
Hospitals managing patient diagnostics and treatment plans.
4
Clinics handling routine screenings or specific diagnostic tests.
5
Public health units monitoring disease outbreaks and public health concerns.
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What are the instructions for submitting this form?
Submit the completed form via fax to 416-235-6556 or toll-free at 1-877-604-4567, or by email to customerservicecentre@oahpp.ca. Ensure the form is filled accurately and completely to avoid delays in processing. Double-check all patient, submitter, and specimen information before submission. For physical submission, send to: Public Health Ontario, Laboratory Customer Service, 661 University Avenue, Suite 1701, Toronto, Ontario, M5G 1M1. Ensure timely submission per the specified deadlines and follow up if necessary to confirm receipt and processing.
What are the important dates for this form in 2024 and 2025?
Important dates for this form include January 2024 for the latest version update and ensure familiarity with key submission deadlines throughout the year.
What is the purpose of this form?
The purpose of this form is to facilitate the accurate and timely submission of specimens for laboratory testing by Ontario health care providers. Proper completion ensures that all necessary patient, submitter, and specimen information is provided, allowing the laboratory to perform the requested tests accurately and efficiently. It also assists public health units in monitoring and managing public health concerns effectively.
Tell me about this form and its components and fields line-by-line.
- 1. Patient Information: Contains fields for patient details including health card number, date of birth, full name, and address.
- 2. Submitter Information: Requires details about the health care provider, including license number, full name, and contact information.
- 3. Patient Setting: Identify the current patient encounter setting, such as clinics, long-term care homes, or emergency rooms.
- 4. Testing Indications/Criteria: Specify the reason(s) for testing, which may include diagnosis, screening, or post-mortem analysis.
- 5. Signs/Symptoms: Provide clinical information, including onset date and specific symptoms such as fever, rash, or respiratory issues.
- 6. Relevant Exposures/Travels: Detail any recent travel or exposure history relevant to the patient's condition.
- 7. Specimen Information: Indicate the type of specimen collected and the date it was collected, along with any additional submitter lab number.
- 8. Tests Requested: List the specific assays requested, ensuring clarity and legibility to facilitate accurate testing.
What happens if I fail to submit this form?
Failure to properly complete and submit this form could result in delays or cancellations of laboratory tests.
- Delayed Test Results: Incomplete or inaccurate forms can lead to delays in processing specimens and obtaining test results.
- Test Cancellation: If required fields are missing or incorrect, the submitted tests may be cancelled, necessitating resubmission.
- Public Health Risks: Inaccurate submissions can affect public health monitoring and response efforts for diseases of public health significance.
How do I know when to use this form?
- 1. Submitting Patient Specimens: Use this form to provide necessary patient and specimen information for accurate laboratory testing.
- 2. Routine Diagnostic Testing: For routine diagnostic tests such as hepatitis screening and STI testing, complete this form to request the specific assays.
- 3. Public Health Investigations: In cases of outbreaks or public health investigations, utilize this form to submit relevant specimens for analysis.
- 4. Monitoring Disease Spread: Use this form to assist in tracking and monitoring the spread of diseases within the public health system.
- 5. Submitting Follow-up Specimens: For follow-up or convalescent testing following initial results, complete this form with updated specimen and patient information.
Frequently Asked Question
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Simply open the PDF form on PrintFriendly, click on the fields you need to edit, make the necessary changes, and save the document.
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Open the PDF on PrintFriendly, use our signature tool to add your signature, position it in the appropriate field, and save the PDF.
How do I fill out the patient information section?
Accurately enter all patient details, including health card number, date of birth, full name, and address. Ensure this information matches the specimen container.
What should I include in the submitter information section?
Provide the health care provider's license number, full name, and contact details, ensuring all information is accurate for test approval and result transmission.
How do I specify the test(s) requested?
List each assay name clearly as per PHO's test menu, being as specific as possible to ensure proper testing and results.
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What if I need to include additional test requests?
Submit a new specimen and requisition for any additional tests, as no further tests can be added to a previously submitted specimen.
How do I handle travel and exposure information?
Provide detailed travel and exposure history relevant to the patient's condition, as this information may be necessary for test approval and interpretation.
Can I use pre-populated fields in the form?
It is recommended to avoid pre-populated fields as they may be outdated or erroneous. Ensure all fields are current and applicable if pre-populated requisitions are used.
How long does it take for test results to be processed?
Turnaround times for test results depend on the specific tests and the accuracy of the submitted information. Ensure all required fields are completed to avoid delays.
