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Lab Requisitions

Please speak to Dr. Pai or your clinical team before using the available lab requisitions. All results are copied to Dr. Pai and your family doctor. Thanks for respecting these guidelines to help our clinic become more efficient and accessible to all patients!

Blood Sample

To be used at LifeLabs, Gamma Dynacare, or any community laboratory.

Stool

Stool requisition for: Ova & Parasites, Bacterial Culture & Sensitivity, and C. difficile. To be used at LifeLabs, Gamma Dynacare, or any community laboratory. (Note: you must print both pages unless instructed otherwise)

Wooden Stool

Stool requisition for: Ova & Parasites, Bacterial Culture & Sensitivity, and C. difficile. To be used at LifeLabs, Gamma Dynacare, or any community laboratory. (Note: you must print both pages unless instructed otherwise)

Image by Diana Polekhina

Stool requisition for fecal calprotectin.

*Note: patient pays out-of-pocket when this test is obtained at a community lab

Preparing for Blood Test

To be used at LifeLabs, Gamma Dynacare, or any community laboratory.

*Note: patient pays out-of-pocket when this test is obtained at a community lab

Lab Requisitions/Forms: Accepted Insurance
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