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PHRQ_VIR_0001F

Virology Requisition

This requisition goes with swabs, CSF, feces and other samples sent for viral testing at the BC Centre for Disease Control's Public Health Laboratory. The lab needs the sample site, the container and, for several tests, exposure or travel history before it will run them.

At a glance

Checked October 2026

Form number
PHRQ_VIR_0001F
Issued by
BCCDC Public Health Laboratory (PHSA)
Where
British Columbia
Completed by
Ordering practitioner
Format
Fillable PDF
Language
English

What the virology requisition is for

This form orders viral detection at the Public Health Laboratory, mostly by PCR on swabs, fluids and feces. It covers respiratory viruses, herpes viruses and mpox from skin and mucosal sites, encephalitis panels on CSF, the gastrointestinal viral panel, and measles, mumps and rubella. Version 1.0 dates from August 2026. Antibody tests go on the Serology Screening or Zoonotic requisitions.

Who completes it

The ordering practitioner completes and signs it. The lab completes the date received and the referral laboratory box used for viral typing. Highlighted fields are mandatory.

How to fill in the requisition

Section 1: Patient and provider information

Give the personal health number, name, date of birth, sex, address and contact number, with the collection date and time. Two matching unique identifiers must be on the container and the requisition. Add the ordering practitioner’s MSP number and delivery address, and up to three copy recipients.

Respiratory

Indicate the sample site (nasopharynx, nares, oropharynx, throat, lower respiratory tract or other) and the container (swab with transport medium, saline gargle or other). Then tick COVID-19, influenza A and B with RSV, avian influenza, enterovirus D68 or another test.

Skin, mucosal and encephalitis

For skin and mucosal samples, give the anatomical site and choose lesion, mucosal lesion or mucosal non-lesion, then HSV 1 and 2 with VZV, mpox, molluscum contagiosum or other. For CSF, choose the HSV, VZV and enterovirus panel, West Nile virus, Creutzfeldt-Jakob disease or other.

Gastrointestinal, MMR and exposure history

Feces can go for the gastrointestinal viral panel or enterovirus. For measles, mumps or rubella, pick the sample type in the matching column. Fill in the relevant exposure, travel or outbreak information wherever the form flags it as required.

Common reasons it’s delayed

  • No sample site or container type for a respiratory sample.
  • An approval-required test sent without approval, or outside its season.
  • Avian influenza ordered with no exposure location.
  • A measles request with no vaccination or travel information.
  • CSF from an infant under six months sent here instead of BC Children’s and Women’s.

Submitting and who pays

The samples and requisition go to the Public Health Laboratory at 655 West 12th Avenue, Vancouver. The eLab Handbook gives sample collection details for each test. The requisition has no billing section.

Get the official form

Download the current version from BCCDC Public Health Laboratory (PHSA) each time. Forms change without notice, and an old edition can be returned.

Official page ↗ PDF ↗

Medulla Forms

Fill PHRQ_VIR_0001F from the visit and the chart.

Upload the fillable PDF to your practice's forms once. Medulla fills it from the visit and the chart open in your EMR, leaves blank anything the record doesn't support, and opens the form for your review. When it's done, save it to the patient's chart in one click.

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Sources for this guide

Questions

Questions we hear a lot.

Do I need approval to test for avian influenza?

Yes. The form marks avian influenza, such as H5, as needing approval and an exposure location. Enterovirus D68 needs approval outside August to October, and West Nile virus CSF testing needs approval outside July to September.

Where do I order hepatitis C RNA?

Not on this form. The virology requisition directs HCV RNA and genotyping to the Serology Screening Requisition.

Which samples does the lab want for a measles workup?

The measles column lists a nasal or nasopharyngeal swab, a throat swab and urine. Tick recent MMR vaccination or recent travel where they apply, and give the travel history.

Where should CSF from a young infant go?

The form says CSF from infants under six months should go directly to the BC Children's and Women's Hospital laboratory for testing that includes parechovirus.

Is patient information secure?

Yes. Medulla has a SOC 2 Type II report from an independent auditor, is HIPAA, PIPEDA, and PHIPA compliant, and is built and hosted in Canada, so patient data stays in the country and never gets pasted into consumer AI tools. Everything is encrypted in transit and at rest. See how we protect patient data.

More questions? Browse help.medulla.ca.