Acceptance Criteria for Specimens/Test Requests

Test Request (Requisition) Requirements

SAMPLE TYPE	MAJOR			MINOR	ADDITIONAL PREFERRED INFORMATION
	STANDARD REQUIREMENTS			OTHER REQUESTED INFORMATION
CLINICAL	NAME IDENTIFIER	UNIQUE IDENTIFIER	SAMPLE SPECIFIC
General Laboratory	Patient's full first and last name (OR coded name for confidential patients OR temporary ID for unknown patients)	At least one (preferably two) of the following assigned identifiers (in order of priority): 1. ULI (Unique Lifetime Identifier) 2. Personal Health Insurance # (e.g. PHN) 3. Personal Identification Number (e.g. Federal, Military, RCMP, Refugee, Immigration, Passport, etc.) 4. Facility Assigned Number (e.g. Hospital # / Clinic # / Unit # / Account # / Accession #) 5. Date of birth accepted until July 1, 2011	- Body site/sample type (if applicable)* - Relevant clinical history (if applicable)* - Reason for request (for qualitative toxicology testing)*	- Date of Birth (DOB) - Gender - Collector ID (as required) - Address / location of patient - Phone number of patient (as required) - Collection date and time - Test(s) / procedure(s) ordered - Full first and last name of requestor - Location / address of requestor - Full first and last name of recipient, "copy to" recipient(s) and/or program name(s) - Location / address of recipient, "copy to" recipient(s) and/or program - EI Number (if applicable in outbreak situations)* Notifiable communicable diseases as per Public Health Act** - Infected persons full name, personal health number, date of birth, age, gender, full address, and telephone number - The name of the disease of infection agent - The name of the physician who ordered the laboratory test - The name of the reporting laboratory	- Priorty status if other than routine - Phone/fax number of requestor and recipient - Physician identification number (e.g. practitioner ID) - Referral Lab's accession number (if available) Therapeutic Drug Monitoring (TDM) Samples: - Time of last dose - Time of next dose - Length of time on current dosing regimen Transfusion Medicine: - Required blood component / product and volume / dosage - Date and time of request - Date and time of intended transfusion
Transfusion Medicine			- Blood Bank Identification Number (BBIN) when testing is the purpose of transfusing the patient* - Identifier (witness) ID when testing is the purpose of transfusing the patient* - Collector ID - Special requirements (if applicable) - Relevant clinical history (if applicable)
Pathology. Cytology. Microbiology, Genetics			- Exact site (e.g. laterality, lobes, quadrants, etc.), organ of origin and procedure type (if applicable) - Relevant clinical history (if applicable) - Devitalization and tissue fixation time (if applicable)
Newborn Metabolic Screening	Use name identity at time of sample collection	If ULI pending (i.e. adoption, home birth) use Date of Birth	- Date and time of birth - Date and time of collection

* Refer to Guide to Laboratory Services for specific /additional requirements
** Refer to the Public Health Act for additional information

SAMPLE TYPE	MAJOR			MINOR	ADDITIONAL PREFERRED INFORMATION
	STANDARD REQUIREMENTS			OTHER REQUESTED INFORMATION
NON CLINICAL	NAME IDENTIFIER	UNIQUE IDENTIFIER	SAMPLE SPECIFIC
Infection Control, Pharmaceutical, Animal, etc.	Name of submitter (e.g. name of agency/business, animal owner)	Sample Source/type (e.g. food item, animal type, drug name)	Relevant history (if applicable)*	- Collection date and time - Test(s) / procedure(s) ordered - Full first and last name of requestor - Location/address of requestor - Full first and last name of recipient, "copy to" recipient(s) and/or program name(s) - Location / address of recipient, "copy to" recipient(s) and/or program - EI Number (if applicable in outbreak situations)*	- Priorty status if other than routine - Phone/fax number of requestor and recipient - Physician identification number (e.g. practitioner ID) - Referral Lab's accession number (if available)

* Refer to Guide to Laboratory Services for specific /additional requirements

SAMPLE TYPE	MAJOR		MINOR	ADDITIONAL PREFERRED INFORMATION
	STANDARD REQUIREMENTS		OTHER REQUESTED INFORMATION
ENVIRONMENTAL	UNIQUE IDENTIFIER	SAMPLE SPECIFIC
Water, Ice, or Biological Indicator	Accession number or Identification number	Relevant history (if applicable)*	- Collection date and time - Name and phone number of collector - Name and address of recipient - Resample (Y/N) - Legal land description - Sample source/type - Sterilizer name/number - FID #

* Refer to Guide to Laboratory Services for specific /additional requirements