Test Requisition Form

Test Requisition Form

A test requisition form must be submitted for each patient. If multiple specimens are submitted on one patient which require separate transportation conditions, please use separate biohazard bags and forms.

Please indicate all tests being ordered on the Test Requisition.

Please complete all the following information in this section.

  • Patient Name
  • Date of Birth
  • Gender
  • HKID/Passport No./other (please specify)
  • Contact (phone/email)

All ordering physicians must provide complete information for successful billing.

The date of collection is a very important, often overlooked piece of information. If the actual transport time exceeds the recommended time frame, then the integrity of the results may be compromised. It is also essential in determining the order of specimens in serial testing.

Physicians Info

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