BC's standard requisition for common outpatient laboratory tests, approved by the Minister of Health under the Laboratory Services Act and maintained by Provincial Laboratory Medicine Services. Clinicians use it to order hematology, urine, chemistry, lipid, thyroid, microbiology, hepatitis and stool tests, with asterisked tests tied to BC Guidelines. The patient takes it to a laboratory of their choice, and the current edition is dated 2026/05/15.
The ordering practitioner completes everything except the collection boxes: billing, practitioner and copy-to details, patient identification, diagnosis, medications, tests and signature. The collector fills in the collection date, time and collector fields; pharmacists order on their own version, HLTH 1946.
Tick one payer: MSP, ICBC, WorkSafeBC, Patient or Other, and specify the other payer. For ICBC or WorkSafeBC, enter the claim number in the ICBC/WorkSafeBC Number box beside the Personal Health Number. Provincial policy lists outpatient billing information among the data every approved requisition must capture, because it determines correct benefit coverage. Fields highlighted in yellow on the form must be completed.
Enter your address, phone and MSP practitioner number. If you work from more than one clinic, indicate the address where results should be sent. A locum names the practitioner they are covering and gives that practitioner's MSP number. For a STAT order, add a contact telephone number. Two Copy to lines take each recipient's MSP practitioner number and clinic name and address; policy expects results to be copied where the patient continues care, such as the family physician or, for an unattached patient, the clinic they attend.
Enter the Personal Health Number, the patient's last and first names, date of birth as YYYY MM DD, and sex (M, F, X or UNK). Answer Pregnant? yes or no and record fasting hours in the Fasting? h pc box. Give primary, secondary and other contact numbers and the full address with postal code. Collectors label every specimen with the patient's first and last name, date of birth, PHN and site, so these details must match the patient's identification.
Write the working diagnosis, and list current medications and antibiotics with the date and time of the last dose. The policy manual requires space for diagnosis, relevant history and current medications because laboratories need them to complete and interpret testing. Antibiotic timing affects cultures and drug timing affects monitored levels. Anticoagulant use is also asked again beside the INR box in the hematology section.
Hematology offers the hematology profile, INR (state whether the patient is on an anticoagulant and which one) and ferritin for query iron deficiency. HFE hemochromatosis testing is check one only: confirm diagnosis (ferritin first, then transferrin saturation, then DNA testing) or sibling or parent known to be C282Y/C282Y homozygous (DNA testing). Urine tests are chosen by indication: dipstick for routine screening, dipstick plus culture if indicated, microscopy for nephritis work-up or suspected pediatric UTI, and culture for symptomatic UTI, pregnancy or a pre-urological procedure.
Chemistry covers fasting glucose (minimum 8 hours), random glucose, three glucose tolerance protocols (gestational confirmation, gestational screen and non-gestational), hemoglobin A1c and urine albumin/creatinine ratio. Tick one lipid option only: full profile for baseline or complex dyslipidemia follow-up, follow-up profile (total, HDL and non-HDL cholesterol), or Apo B, which is not available with lipid profiles unless complex dyslipidemia is indicated. Fasting is not required for any panel. Thyroid choices are TSH only for monitoring replacement, or TSH-first algorithms for suspected hypothyroidism or hyperthyroidism; order other thyroid tests separately with a diagnosis.
Routine culture asks about penicillin allergy and the site: throat, sputum, blood, superficial wound, deep wound or other, and deep wound and other sites require clinical information. Genital culture needs the site and history (peripartum, pelvic or genitourinary surgery, other). The section also covers the Group B Strep pregnancy screen by vagino-anorectal swab, chlamydia/gonorrhea and trichomonas NAAT with site, gonorrhea culture, vaginitis (initial, chronic or recurrent, pre-pubertal or post-menopausal), dermatophyte culture or KOH prep with specimen type, and yeast or fungus mycology.
Choose a panel by clinical question: acute viral hepatitis of undefined etiology (hepatitis A IgM, HBsAg plus anti-HBc, anti-HCV), chronic viral hepatitis (HBsAg, anti-HBc, anti-HBs, anti-HCV), or immune status (anti-HAV total or anti-HBs). HBsAg can be ordered alone as a marker; other hepatitis markers go under Other Tests. HIV serology and syphilis screening are single boxes, and the 2026/05/15 edition no longer offers a non-nominal HIV reporting option.
Tick one stool option: the Infectious Diarrhea Panel, which includes C. difficile testing, or C. difficile testing alone. Miscellaneous covers ECG and two FIT options: for asymptomatic patients aged 50 to 74 every two years with a copy to the Colon Screening Program, or FIT with no copy. Other chemistry lists electrolytes, liver tests, creatinine/eGFR, calcium, CK, the two PSA boxes (MSP billable for known or suspected prostate cancer, self-pay for screening), pregnancy test and quantitative beta-HCG.
Write any test not listed under Other Tests. Standing orders need an effective date, expiry date and frequency, and are valid for a maximum of two years; policy requires them on a separate requisition from one-time orders, with frequencies such as daily, weekly or monthly, since PRN orders are handled at the laboratory's discretion. Sign and enter the date signed. The collector completes the date and time of collection and collector fields, and staff note who received a telephone requisition.
Download the current version from the source each time; forms change without notice.
Standard Out-Patient Laboratory Requisition
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Sources for this guide
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Under PHSA's Laboratory Requisitions Manual of Policies, a signed requisition is valid for one year from the date it was signed. A standing order is valid for up to two years, and a post-dated standing order cannot start more than six months after it was written. If a standing order states no expiry, the laboratory defaults to 24 months.
Only until November 15, 2026. A May 2026 PHSA bulletin requires all clinicians and laboratory operators to replace outdated SOPLR and SOPLR-M versions, including organization-branded copies, with the 2026/05/15 editions by that date. Download the current form from the gov.bc.ca link and update EMR templates and saved bookmarks.
The form has two PSA boxes in the Other Chemistry Tests list. PSA for known or suspected prostate cancer is marked MSP billable, while PSA screening is marked self-pay, meaning the patient pays. Tick the box that matches the indication and record the diagnosis in the Diagnosis field.
If the standing order is still in the laboratory's system and fewer than 90 days have passed since it expired, the policy lets the lab process it once as a one-time order. After 90 days, or if no requisition is on file, the patient is asked to contact the ordering practitioner for a new one.