Instruction for completion of the requestion form by ordering physicians:                                       

Every referring site are received requisition forms dedicated to them. IMMLABS’ address and hours of operations are indicated on the requisition according to their site.

To complete the requisition:

1-      Please complete patient information with the followings:

a.       Complete name (family name, name) in the name section

b.       Mark patient gender

c.       Add patient phone number to the specified section

d.       Provide patient MSP if the patient is CUAET

e.       Mark patient category

f.        Add IME/ UMI No.  according to IRCC tracking sheet

2-      Please complete ordering physician’s information:

a.       Ordering physician’s name

b.       Signature

c.       Billing Number

d.       Fax number

3-      Please mark laboratory tests that are requested for the patent.

IFH and CUAET patients will not pay for their exams. Other patients (Private patients) are request to pay at the reception based on the requested examinations: