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Carcinoembryonic Antigen (CEA) Requisition

CEA is an insured service in Ontario only when it monitors an established malignancy under Cancer Care Ontario guidelines. This requisition is where you show that, and pick the hospital laboratory that runs the funded test. Without a funded reason, the patient pays and LifeLabs runs the test.

At a glance

Checked October 2026

Issued by
LifeLabs
Where
Ontario
Completed by
Ordering healthcare provider
Format
Fillable PDF
Language
English

What the CEA requisition is for

The requisition separates funded CEA, which OHIP covers under Cancer Care Ontario guidelines for established malignancies, from non-funded CEA, which the patient pays for. It is a dedicated LifeLabs form for this one test. Dynacare patients use Dynacare’s ONPSC 305 A form for the same criteria.

Who completes it

The ordering healthcare provider completes and signs it. The collection staff add the collection date, time, and their initials. There is no patient section.

How to fill in the requisition

Patient and provider details

Patient name, date of birth, sex, telephone, and health card number, then your name and address and anyone who should get a copy of the report.

Non-funded or funded testing

Tick non-funded testing when the patient doesn’t meet the criteria and agrees to pay. For funded testing, choose one of the listed hospital laboratories. Pick the lab that ran the patient’s previous CEA so serial results stay comparable.

Required information for funded CEA

Enter the date of the last CEA test and tick the reason for ordering. A funded test less than 28 days after the last one won’t be covered, and therapy monitoring shouldn’t repeat more often than every two cycles.

Signature

Sign and date the requisition.

Common reasons it’s sent back

  • Funded testing ticked with no reason for ordering.
  • No date of last CEA, or a date less than 28 days ago.
  • No hospital laboratory chosen for a funded test.
  • A screening request marked as funded.
  • Missing provider signature.

Submitting and who pays

The patient takes the requisition to a LifeLabs patient service centre. Funded testing costs the patient nothing. Non-funded testing is billed to the patient. Questions go to the LifeLabs Customer Care Centre at the number printed on the form.

Get the official form

Download the current version from LifeLabs each time. Forms change without notice, and an old edition can be returned.

Official page ↗ PDF ↗

Medulla Forms

Fill Carcinoembryonic Antigen (CEA) Requisition 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.

When is a CEA test funded in Ontario?

When it follows Cancer Care Ontario guidelines for monitoring an established malignancy: a pre-operative level in colorectal cancer, adjuvant therapy or follow-up for stage II or III colorectal cancer, therapy for resected or metastatic colorectal cancer, or treatment of metastatic breast cancer.

Why does the form ask for the date of the last CEA?

CEA testing more often than every 28 days isn't program funded. The date lets the lab check the interval before running a funded test.

Why choose a hospital laboratory on the form?

Funded CEA tests on this requisition go to one of the listed hospital laboratories. The form recommends keeping serial results in the same lab, because results from different methods can mislead.

What if the patient wants a CEA as a screening test?

Tick non-funded CEA testing. The patient pays, and LifeLabs performs the test.

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.