Requisitions and forms

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Please ensure that you select the requisition matching each ordered test. Failure to complete the appropriate requisition may result in delayed processing and/or rejection of the sample.

The clinical indication for testing, sample type and clear identification of the authorizing provider must be indicated on the requisition to allow for appropriate and timely processing of the samples.

Laboratory requisitions

Standard Cytogenetic Requisition

For chromosome analysis, all FISH testing (including microarray follow up FISH testing) and RAD

Mandatory for all products of conception (POC), intrauterine fetal deaths (IUFD) and stillbirth samples referred for RAD/microarray testing. Also complete a Standard Cytogenetics Requisition. See shipping instructions.

Microarray and Microarray Follow Up Q-PCR Testing Requisition
For microarray and microarray follow up Q-PCR testing

Standard Molecular Requisition
For FMR1-related disorders, hemochromatosis, MCC, muscular dystrophy/atrophy testing, Prader-Willi/Angelman syndrome, thrombophilia, etc.

Cardiomyopathy and Arrhythmia Requisition

For cardiomyopathy, arrythmia and combined cardiomyopathy/arrhythmia panels

Hereditary Cancer Molecular Requisition

Vascular Connective Tissue Disorders and TAAD Requisition
For Arterial Tortuosity, Loeys-Dietz syndrome, Marfan syndrome, TAAD panels

Genome-wide Sequencing Ontario

Requisitions can be found through Genome Sequencing Ontario's website.

For ordering genome-wide sequencing on patients and family members who fulfill clinical criteria for testing, visit the Genome Sequencing Ontario website for more details.

Forms

Consent to Disclosure of Personal or Health Information

License and accreditation

CHEO certificate of accreditation

Laboratory license