What the non-gyn cytology requisition is for
It orders cytology on specimens other than cervical samples: urine, thyroid, salivary gland and lymph node aspirates, pleural, peritoneal and synovial fluid, breast cyst or nodule aspirates, and sputum. Solid tissue biopsies go on Dynacare’s histopathology requisition, and cervical screening uses the Ontario Health HPV and cytology requisition.
Who completes it
The requisitioning clinician or practitioner completes and signs it. The lab completes the section on cell block, fixative and specimen description.
How to fill in the requisition
Clinician and patient details
Give your name, address, CPSO or CNO number, and a number for urgent results, plus any copy-to clinicians. Patient names follow the health card, with the version and expiry, and you mark one payer: OHIP or insured, third party or uninsured, or WSIB.
Specimen collection information
Enter the collection date and time and the number of specimens and slides. Label each bottle with the patient’s name, date of birth, and site.
Specimen type
Tick the specimen and its details: voided, catheterized or bladder washing urine, the side and whether it was a cyst or nodule for thyroid, salivary and breast aspirates, the site for lymph node and synovial samples, or the fluid type.
Clinical history and remarks
The form states that clinical information matters in every cytology interpretation. Give the indication, imaging findings for an aspirate, and any known malignancy.
Signature and certification
Sign and date to certify that the tests are not for registered hospital patients.
Common reasons it’s delayed
- Slide or bottle count that doesn’t match what was sent.
- No side or site for an aspirate.
- No clinical history.
- Bottles labelled without date of birth or site.
- A hospital patient’s specimen sent on a community requisition.
Submitting and who pays
Send the requisition with the specimens to Dynacare at the Brampton address printed on the form, through your usual courier. Billing follows the payer you mark.