Skip to content

Fecal Immunochemical Test (FIT) Requisition for Mailed Colorectal Cancer Screening

The FIT requisition is how you order a FIT through Ontario's ColonCancerCheck program, and the kit is mailed straight to the patient. Since July 1, 2026, average-risk screening starts at 45, so more of your patients now qualify, and the requisition goes to a new lab.

At a glance

Checked October 2026

Issued by
Ontario Health (Cancer Care Ontario), ColonCancerCheck
Where
Ontario
Completed by
Physician or nurse practitioner
Format
Fillable PDF
Language
English

What the FIT requisition is for

The requisition asks ColonCancerCheck’s lab to mail a FIT kit to an asymptomatic, average-risk patient who is due for screening. The program recommends FIT every two years for people at average risk, with a follow-up colonoscopy after an abnormal result. Patients at increased risk because of family history are screened by colonoscopy instead. Since July 1, 2026, that means one first-degree relative diagnosed before 60, or two or more at any age, and screening starts at 40 or 10 years before the youngest relative’s diagnosis.

Who completes it

A physician or nurse practitioner completes and signs it. Mobile coach and Health811 requesters have their own requester types on the form. There’s no patient section, but the result letter and other correspondence go to the patient address you enter, so check it.

How to fill in the requisition

Eligibility and replacement kits

Read the eligibility criteria at the top before you start: age 45 to 74, asymptomatic, due for screening and OHIP-covered. Tick the replacement box only when an earlier kit was lost, damaged or never received, and give an updated date in Section 4.

1. Requester information

Choose physician, nurse practitioner, mobile coach or Health811, and give your CPSO or CNO number, name, address, phone and fax. Complete the copy-to section only if results should also go to someone else, such as the nurse in charge at a nursing station.

2. Patient information

Enter the name, date of birth, OHIP number and sex exactly as they appear on the OHIP card, plus the address and primary phone number. Ontario Health sends the result letter to this address, so confirm the address and date of birth with the patient before you send the form.

3. FIT kit mailing address

Fill this in only when the patient wants the kit mailed somewhere else in Ontario, such as a health centre or nursing station.

4. Requester verification

Sign and date the form. Replacement requests need a new date here.

Common reasons it’s rejected

  • Missing or inaccurate information in any section, which the form says may lead to rejection.
  • A patient outside the eligible age range, or one with symptoms, bleeding or anemia.
  • Names or a date of birth that don’t match the OHIP card.
  • A replacement request with no updated date.
  • The form faxed to the old lab instead of In-Common Laboratories.

Submitting and who pays

Fax the completed requisition to In-Common Laboratories at 1-833-520-1544. The kit is mailed to the patient, and Ontario Health sends them a letter with the result and next steps. For abnormal results, contact the patient and refer for colonoscopy as soon as possible. The form prints Q150A as its form completion fee code, which you bill to OHIP. Medulla can suggest the requisition when the visit plan includes colorectal screening.

Get the official form

Download the current version from Ontario Health (Cancer Care Ontario), ColonCancerCheck each time. Forms change without notice, and an old edition can be returned.

Official page ↗ PDF ↗

Medulla Forms

Fill Fecal Immunochemical Test (FIT) Requisition for Mailed Colorectal Cancer Screening 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.

Free 1-month trial. No credit card required.

Sources for this guide

Questions

Questions we hear a lot.

Who is eligible for a ColonCancerCheck FIT?

People aged 45 to 74 with OHIP coverage who have no symptoms and are due for screening, meaning no FIT in the last two years and no flexible sigmoidoscopy or colonoscopy in the last 10 years. Requisitions are accepted up to age 85, where screening between 75 and 85 is a decision about risks and benefits.

Where do I fax the FIT requisition?

To In-Common Laboratories at 1-833-520-1544, as printed on the form. FIT requisitions went to LifeLabs before the July 2026 changes.

Can I order a FIT on the regular lab requisition?

No. The Ontario laboratory requisition (4422-84) says the ColonCancerCheck FIT test needs its own requisition, which is this form.

Can I use FIT for a patient with rectal bleeding or anemia?

No. The form says not to use it to work up GI symptoms, overt GI bleeding or anemia, or for patients with a history of colorectal cancer, Crohn's disease of the colon or ulcerative colitis.

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.