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Test Request/Media Order Forms

Familiarisation with Pathology Laboratory Services on the availability of the types of tests in the different disciplines, laboratory operating hours, laboratory collection service, types of emergency/stat tests and many others would be very useful prior to placing test requests.
Specimens are to be submitted together with authorised Test Request Forms or electronic requisition, or written requests with authorised requestor's name. Self-referral by patient or direct to consumer testing will not be accepted. 

Test Request Form

If Test Request Forms are used, please use the correct test request form to accompany the patient’s sample so that it can reach the appropriate laboratory without unnecessary delay. Tick the appropriate box/boxes on the request form. To order tests that are not listed on the form, write the name of the test in the space marked "Miscellaneous" or "Others".
"REQUEST FOR LABORATORY SERVICES" form can be used for private referrals (e.g. by General Practitoners).
All information requested in the form should be given as this is essential for proper processing of samples and correct interpretation of test results. The following forms are used in Singapore General Hospital when requesting for various laboratory tests.


Types of test requestsRequest Form to use
Bacteriology, Mycology, ParasitologyRequest for Bacteriological Investigation
Clinical BiochemistryRequest for Biochemical Analysis
Blood Bank (Transfusion Medicine)Request for Blood and Blood Products
Request for Immunohaematological Investigation
Cytogenetics, Molecular CytogeneticsRequest for Cytogenetics Investigation
Cytology (Cervical PAP Smears)Request for Cervical Pap Smear Cytology
Cytology (FNA, body fluids, etc.)Request for Histopathological Investigation
HaematologyRequest for Haematological Investigation
Request for Coagulation Studies
Request for Urinalysis
Request for Haematological Investigation (Special)
HistopathologyRequest for Histopathological Investigation
Immunology, Serology, STD & AllergyRequest for Immunological Investigation
MolecularRequest for Virological Investigation Molecular Test
MycobacteriologyRequest for Mycobacteriology Investigation
VirologyRequest for Virological Investigation
Client and Specimen ManagementRequest for Laboratory Services
 Request Forms Download 
 Bacteriological Investigation Click Here 
 Biochemical Analysis
Click Here
 Blood and Blood Products Click Here 
 Coagulation Studies
Click Here
 Cervical PAP Smear Cytology Click Here
 Cytogenetics Investigation Click Here
 Haematological Investigation Click Here
 Haematological Investigation (Special) Click Here
 Histopathological Investigation Click Here 
 Immunohaematological Investigation Click Here
 Immunological Investigation Click Here
 Laboratory Services Click Here
 Mycobacteriology Investigation Click Here
 Urinalysis                                                                                                                       Click Here
 Virological Investigation Click Here
 Molecular Investigation
Click Here
 Consent Forms Download 
 Consent Form for Phlebotomy Services - Patient Click Here
 Consent Form for Phlebotomy Services - Legal Representative  Click Here

​ Consent Form for Karyotyping/Fluorescence In Situ Hybridization (FISH) for Constitutional Genetic  

Click Here
 Others Download
 Media Order Form Click Here
 Step Guide on Sending Glass Blood Culture Bottles (via PTS) Click Here
Please print all information clearly and legibly on all test request forms.

Patient Identification

Correct spelling of patient’s name and other biodata given are essential to ensure that the specimen collected and received by the laboratory comes from the correct patient.
  • Patient’s name 
  • Patient’s NRIC number or Passport number 
  • Hospital Registration or Account number 
  • Date of birth 
  • Sex 
  • Nationality 
  • Others, e.g. first twin or second twin 

Patient Location

The patient’s exact location should be stated clearly so that the laboratory can communicate promptly with the relevant referring clinic/ward/department/hospital should the need arise.
  • Name of Hospital 
  • Name of Clinic/Department 
  • Ward number 
  • Bed number 
Non-hospital or clinic clients should include the name, address and telephone number of their organisation. An e-mail address and Fax number should be included if available for alternative means of communication. It is important to include the name of the contact person in the organisation for the return of reports, and the name and contact number/e-mail address of the requesting doctor for discussion of the case if this is needed.

Name of Requesting Doctor/Consultant/Authorised Requestor

This information is important for the laboratory to contact the relevant physician/authorised requestor when necessary. The MCR number of the requesting physician should be included if hard copy test request is used. The specimen may be rejected if the requesting physician's name is not given.

Clinical History

  • Clinical diagnosis 
  • Suspected disease/organism 
  • Brief clinical history 
  • Name, date and duration of treatment given 
  • Any previous test results with dates and previous laboratory numbers 
  • Patient’s immune status (e.g. any underlying diseases, cancer chemotherapy, immunosuppressive treatment) 
  • Any other relevant patient or clinical data requested in 'Special Instructions' of each laboratory discipline. 
  • Specimen may be rejected if no diagnosis or clinical history is given. This applies especially to Histopathology, Cytology, Cytogenetics and Virology investigations 

Nature of Specimen

Identify the specimen source by indicating the specific body site from which specimen had been taken.
Persons who coordinate the collection of specimens at sites remote to the SGH Campus must be aware that there are tests that have unique or stringent requirements and are therefore not suitable for collection outside the SGH Campus or other SingHealth institutions. Such specimens, if collected, will be rejected. Please refer to the following tables for specimens that can/cannot be collected at SingHealth Polyclinics and by Alternative Phlebotomists, respectively.
  • Specimens collected at Singhealth Polyclinics Laboratories for SGH Campus Institutions. Click here for details. 
  • Specimens collected at Singhealth Polyclinics Laboratories for KKH. Click here for details. 
  • Specimens collected at Singhealth Polyclinics Laboratories for CGH. Click here for details.
  • Specimens collected by Alternative Phlebotomists (Personnel who are not designated staff of SGH or Referring Institution/Clinic/Physician). Click here for details
A consent form must be completed for all alternative phlebotomy services, to be signed by the phlebotomist and the patient. For patients under 21 years of age, or patients who lack the capacity to give consent, a separate consent form needs to be completed and signed by the phlebotomist and the patient’s legal representative. Specimens collected by alternative phlebotomy service and not accompanied by the appropriate consent forms will not be accepted.

Date and Time of Specimen Collection

The actual date and time of specimen collection should be indicated for proper evaluation of test results.

Emergency or Stat Test

Clearly indicate this on the test request. Make sure that the telephone numbers of the named person to whom results should be given are provided.


Local Clients

Private medical practitioners, contractual clients and other private organisations will receive our bills monthly for all the different types of tests done. Payment can be made by cheques.

Regional Clients

Payment from regional clients can be made via bank draft or telegraphic transfer. A remittance advice should be sent to inform us. All payment must be made in Singapore dollars and bank charges are to be borne by clients.