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General Laboratory Requisition

General Laboratory RequisitionAppointment Booking & Locations: or Alberta Precision Laboratories 1-877-868-6848 DynaLIFE Medical Labs 1-800-661-9876 or 780-451-3702 21302(Rev2021-11)o Routine o Stat Requisition Date Denotes a Fasting Test. Refer to Patient Instruction Fasting _____o Third Party BillClient _____Hematology/CoagulationEndocrineClin ical Informationo CBC and Differential o CBC no Differentialo D-dimero INRo Reticulocyte CountCortisol o Random o AM (0700-1000) o PM (1500-1800)o Estradiolo Follicle Stimulating Hormone (FSH)o Luteinizing Hormone (LH)o Parathyroid Hormone (PTH)o Progesteroneo Prolactin o Testosterone, Total o Thyroid Stimulating Hormone (TSH)o Thyroid Stimulating Hormone (TSH)

General Laboratory Requisition Appointment Booking & Locations: www.albertaprecisionlabs.ca or www.dynalife.ca Alberta Precision Laboratories 1-877-868-6848 DynaLIFE Medical Labs 1-800-661-9876 or 780-451-3702

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