Health PEI's provincial requisition for blood testing at the Provincial Clinical Laboratory and hospital collection sites across the Island. It covers chemistry, cardiac markers and lipids, glucose and lactose tolerance tests, nutritional, endocrine and tumour markers, blood gases and ANA screening, with tube types noted. The reverse lists collection sites and gives tolerance-test and therapeutic drug monitoring instructions; the current edition is marked 2021.
The ordering physician or nurse practitioner completes payment responsibility, patient details, relevant diagnosis and therapy, provider and copies, and ticks the tests. The person collecting the specimen records who collected it, the date and time, and fasting status.
Download the current version from the source each time; forms change without notice.
Laboratory Blood Test Request Form
Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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Tick the test on the Laboratory Blood Test Request Form and book an appointment, which the ordering physician or NP must arrange. The 50 g gestational screen needs no fasting, while the 75 g confirmatory tests, the post-partum screen and the lactose tolerance test require an overnight fast of at least 8 hours.
Chemistry is collected in one yellow SST tube, glucose needs a grey tube, BNP a purple tube and troponin a green tube. Ammonia and lactate go in green tubes on ice, intact PTH in a red tube, and blood gases in a heparinized syringe sent on ice.
Yes. Use the Additional Requests area and contact the laboratory for special instructions and availability, as the form directs. Some tests have their own Health PEI forms, including urine, body fluid and CSF tests, microbiology serology, serum allergy testing and blood transfusion requests, all listed on the laboratory requisitions page.