Just the Facts: Filling Out the Public Health Lab Requisition

Failure to fill out the lab requisition properly could result in rejection of the sample, or cause a delay in test result reporting. Leaking specimens will not be processed!

Section 1

  • Physician: Dr. Mehdi Aloosh
  • Phone: 519-258-2146
  • Fax: 226-783-2132
  • The name of the family or facility’s doctor can be entered here as well, and they will also receive a copy of the results.
  • Agency: Windsor-Essex County Health Unit
    1005 Ouellette Avenue, Windsor, ON N9A 4J8

Section 2

Must be completely filled out.

If the patient is from a Long-Term Care Home, please write the name of the home in this section. Remember to include the outbreak number for this outbreak (if known).

Section 3

Tests Required

Enteric – stool specimens

Respiratory – nasopharyngeal specimens: Influenza A, B (Flu) Virus Detection

Direct test for Influenza and RSV if suspected. Direct test will apply to the first few specimens only in an influenza outbreak.

Unless otherwise ordered by the Windsor-Essex County Health Unit:

All samples must be transported to the Public Health Lab in London, Ontario in approved packaging by calling the Health Trans Courier 519-791-0515 after 8 a.m.

Examples of approved packaging: a soft-sided cooler bag, or a box that is sealed and labelled, SPECIMENS.

Section 4

All applicable boxes must be filled in.


Attention: Outbreak Team.

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