REQUISITION FORMS

Please note that incomplete requisition forms will result in a delay of sample testing.

NIBDGL employees are not bilingual.  Please write in English if possible.

 

 

 

 

Instructions for sample collection and shipment as well as patient consent forms are included with the requisition forms.

 

Completed requisitions must sent with patient sample to the following address:

Attn: Shawn Tinlin/Gina Jones

Department of Pathology and Molecular Medicine, Queen's University

Richardson Laboratory, Room 201

88 Stuart St., Kingston, Ontario K7L 3N6

 

Tel: 613-533-3187

Fax: 613-533-2907

NIBDGL@clinlabs.path.queensu.ca

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SAMPLE SHIPMENT

ENGLISH

FRENCH

SAMPLE

© 2018 by the National Inherited Bleeding

Disorder Genotyping Laboratory