Forms and Requisitions
- Retrovirus Nucleic Acid Testing Requisition
- Manitoba Maternal Serum Screen
- Supplies Request Form
- General Requisition Form[fillable]
FREQUENTLY ASKED QUESTIONS
General
1. There is no longer a requisition number, but there are still stickers on the bottom; do I need to use them?
Not necessarily. The stickers are intended as an aid to provide two unique identifiers clearly on the specimen or VTM container. In many situations the stickers do not provide an additional benefit for specimen labeling. Some centres instead use the sticker to keep track of specimens sent to CPL, either in the patient chart or a log book.
2. What 2 identifiers should I use on the non-nominal HIV specimens?
The non-nominal HIV requisition is not changing (MG 13396); continue to record the requisition number and patient code on the specimen. Order this requisition using the Supplies Request Form.
3. How will I get the results without a requisition number?
Call CPL using the patient name or PHIN for assistance with outstanding or misplaced reports.
4. Is this CPL’s only requisition now?
No. Newborn screening, maternal serum screening, non-nominal HIV and HIV viral load requisitions will all remain as is.
5. How do I get more requisitions?
Use our Supplies Request Form and fax in your request to 204-786-4770.
6. I see there is a section for “C & S” in bacteriology. Should I be sending general bacteriology specimens to CPL now?
Do not change current referral practices for microbiology. CPL is not accepting more general bacteriology and is focusing instead on public health bacteriology. Refer microbiology specimens using your current referral routes.
Serology
1. What tick box do I use if I want to test, source or exposed client panel but do not want HIV included?
Check the Post Exposure or Source Panel and write NO HIV in space beside panel.
2. How do I know what tests are included in the panel?
On the back of the requisition is information regarding the tests included in panels. Posting the back page may help staff become accustomed to the new requisition during the transition
3. I have 3 ova and parasite samples for the same patient. Can I submit them on one requisition?
No. A separate requisition is required for each sample otherwise our system cannot distinguish them as separate samples. For ease, consider photocopying the first requisition for the other 2 samples and write in the separate specimen information date/time for each sample.
4. How do I just order a routine HIV test?
Under Serology: Tick HIV-½ Ag/Ab combo.
For Non-nominal HIV testing, use requisition MG # 13396.
5. There is no STORCH box to tick. What do I tick for a STORCH with HIV?
Select from among the appropriate tick boxes for a “STORCH” type request.
Syphilis 
Screen
| for the Infant select from | for the Mother select from |
for Stillbirth | ||
|---|---|---|---|---|
| Toxo | IgM |
IgG |
both |
|
| Rubella | IgM |
IgG |
both |
|
| CMV | IgM |
IgG |
both |
|
| HSV | IgM |
IgG |
both |
|
Retrovirus HIV ½ Ab
Cadham Provincial Laboratory |
