Request Form

Laboratory test request to be submitted with an authorised Test Request Forms or electronic requisition together with a labelled specimen. Self-referral by patient or direct to consumer testing will not be accepted.

For manual test request, please ensure the correct form is used. Fill in all the information requested in the form as this is essential for proper processing of samples and correct interpretation of test results.

To order tests that are not listed on the form, write the name of the test in the space marked "Others".

The following forms are used in KK Women's and Children's Hospital when requesting for various laboratory tests.

Request Forms	Download
67010-Form-0070	Click Here
Allergy Lab Test Form	Click Here
Bacteriology, Mycology, Parasitology Tests	Click Here
Biochemical Genetics Lab	Click Here
Clinical Chemistry - Form A	Click Here
Clinical Chemistry - Form B	Click Here
Gynaecological Cytology	Click Here
Haematology/Coagulation	Click Here
Histopathology Lab	Click Here
HSA-Form	Click Here
Immunlogy Tests	Click Here
Immuno-Chemistry Virology & Serology	Click Here
Immunohaematology	Click Here
Lab Cytogenetics	Click Here
Molecular Histopathology	Click Here
Non-Gynaecological Cytology	Click Here
Platelet Immunology Test Request Form	Click Here
Quantiferon Test Form	Click Here
Therapeutic Drug Analysis Lab	Click Here
Urine Tests	Click Here
Virology & Serology Tests	Click Here
Consent Forms	Download
Chromosome Microarray Request and Consent Forms	Click Here
ClinGen Request General Constitutional Consent forms	Click Here
ClinGen Request Prenatal Constitutional Consent forms	Click Here
Post-mortem Examination - An Explanation for Parents and Legal Guardians Booklet	Click Here
Karyotyping / Fluorescence In Situ Hybridisation (FISH) for Constitutional Genetic Testing	Click Here
Prenatal Chromosome Microarray Analysis	Click Here
Others	Download
Memo For Laboratory Request	Click Here
Memo For Specimen Media Request	Click Here

Patient Identification

Patient name, demographics and biodata provided are essential to ensure that the specimen collected and received by the laboratory comes from the correct patient.

Patient’s name
Patient’s NRIC number / FIN
Account number
Date of birth
Gender
Nationality

Patient Location

The patient’s exact location should be stated clearly so that the laboratory can communicate promptly with the relevant referring clinic/ward/department/hospital should the need arise.

Name of Clinic/Department
Ward number
Bed number

Name of Requesting Doctor/Consultant

The information of requesting doctor/consultant is important for the laboratory to contact the relevant requestor when necessary for clarification and result reporting. MCR number of the requesting doctor should be clearly writtien if a hard copy request form is used.