Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by filling in the details of the ordering physician, including their name and contact information.
3. Enter the patient's unique personal health number (PHN) along with their full name, address, city, province, phone number, and postal code.
4. Provide the patient's date of birth and select their gender by marking the appropriate box.
5. If applicable, indicate the copy physician's address and contact details.
6. Select the type and source of specimen being submitted, marking one or more checkboxes that apply.
7. Complete the general history section by indicating any symptoms that are present, if required.
8. If there has been recent travel, specify the country and date of return.
9. Choose relevant antibody tests based on past exposure or immunity by marking the appropriate boxes.
10. Fill in the blood or body fluid exposure section if relevant, including date and time of collection.
11. Record the date of onset of illness and relevant immunization dates as needed.
12. Select any acute/symptomatic tests required and zoonotic serology tests if applicable, specifying other conditions where needed.
13. Indicate risk information or reasons for testing from Box A, marking boxes that apply.
14. Finally, review all filled information for accuracy before proceeding to save your changes or download, print, or share the completed form.

Complete your Virology Requisition online today for efficient and thorough testing.