Request Form

All laboratory test request must be ordered by an appropriate physician using an authorised Test Request Form or electronic requisition which must accompany an appropriately labelled specimen.

For manual test requests, please ensure the correct form is used. It is important that all information requested in the form is accurately and completely filled in 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". Ensure that any necessary consultation with the appropriate laboratory staff is completed.

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
Gynaecological Cytology	Click Here
Haematology/Coagulation	Click Here
Haematology Bone Marrow Aspiration (BMA) Appointment Booking Form	Click Here
Histopathology Lab	Click Here
HSA-Form	Click Here
Immunohaematology	Click Here
Lab Cytogenetics	Click Here
Molecular Pathology	Click Here
Non-Gynaecological Cytology	Click Here
Platelet Immunology Test Request Form	Click Here
Quantiferon Test Form	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
Memo Blood film despatch to SGH Haematology Laboratory	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 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 identity of the requesting doctor/consultant must be provided in the event the laboratory needs to contact the relevant requestor for clarification and or for critical result reporting. The MCR number of the requesting doctor should be clearly written if a hard copy request form is used.

Nature of Specimen

The specimen site, type of specimen and the source of specimen must be clearly written on the test request form.

Date and Time of Specimen Collection

The specimen collection date and time must be indicated clearly on test request form for proper evaluation of test results.

Test Request Forms

Patient Identification

Patient Location

Name of Requesting Doctor/Consultant

Nature of Specimen

Date and Time of Specimen Collection