Reference Material

In Sixty Material

Direct Referral for Breast Imaging

Direct Referral Memorandum – June 15, 2015Direct Referral Introductory Memorandum – January 26, 2015
FAQ for Primary Care Providers
Requisition Form
Patient Brochure:  “Diagnostic Breast Exams: What to Expect“The brochure helps patients understand diagnostic breast exams and what it means if a patient is referred for additional testing using plain language.To order, please fill out this Work Order, citing “Diagnostic Breast Exams: What to Expect,” from HSC Printing Services and e-mail to:
Call 204-787-4072 for questions about ordering.
You can also download and print the brochure:


Specimen Acceptance Policy 
This safety-driven policy defines the actions and criteria required for the acceptance of laboratory specimens received by Shared Health diagnostic services. The policy supports improved accuracy and efficiency in diagnostic testing and by promoting a significant decrease in unacceptable or incorrectly labeled samples, will contribute to greater accuracy in results, as well as more timely turnaround for physicians and patients.

10-50-03 DSM Specimen Acceptance Policy
170-10-14 Rural Transport of Large Fresh Surgical Samples to Referral DSM Pathology Sites (Replaces policy 90-10-01 – Transportation of Large Surgical Specimens to Referral DSM Pathology Sites )
170-10-08 Handling and Transporting Histology and Cytology Specimens
170-10-19 Requesting Reagents and Supplies from Referral Pathology Laboratories
Critical Values
100-10-06 Reporting Critical Values
110-10-25 Clinical Biochemistry Critical Values
120-10-01 Critical Result Reporting Urban Microbiology Labs
120-20-03 Critical Result Reporting Rural Microbiology Labs
140-10-02 Hematology Critical Values – WRHA

Diagnostic Imaging Requisition Forms

F130-10-08 Diagnositc Imaging Services Request Form
F130-120-1000 Diagnostic Imaging Services Request form (for Northern, Interlake Eastern RHA facilities)

Cardiology Requisition Forms

130-120-7020 Burntwood Request for Cardiology Services

Immunology/Hematology Approval for Test

F150-100-100 Form for Immunology/Hematology Testing Approval

Specimen Collection Information

100-10-79 DSM Phlebotomy Collection Manual – replaces the SBGH Biochemistry Phlebotomy Information Manual.
120-10-05 Clinical Microbiology Specimen Collection Manual
DSM Laboratory Information Manual

Miscellaneous Information / Posters

F100-10-20 Order of Draw Poster
F100-10-20A Proper Labels Poster
F100-10-20B DSM Referral Testing Blood Collection Tube Guide
F120-10-05A Microbiology Specimen Collection Poster – HSC, SBH
F120-10-05B Microbiology Specimen Collection Poster – WL
170-100-29 Protocol for handling cases suspect for Creutzfeldt-Jakob Disease

Miscellaneous Forms

F10-60-19A Request for Access to Laboratory Specimens Without Consent Form
F170-10-12 Authorization for Release of Tissue or Remains for Perinatal Loss

Patient Information / Brochures

PB110-10-17 Patient Instructions for Fasting Glucose Tolerance Test
PB110-10-19ENG FOBT Patient Brochure – English
PB110-10-19FR FOBT Patient Brochure – French
PB110-50-01 Patient Brochure 24 Hour Urine Collection – Bilingual
PB120-10-05A  PB Collection of Stool for Ova and Parasites
PB120-10-05B Collection of Urine for Culture
PB120-10-05C Collection of Urine for Culture using UriSwab
PB120-10-05D Eng Collection of Stool for Culture and Cdiff
PB120-10-05D French Collection of Stool for Culture and Cdiff (French)
PB120-10-05E Eng How to Collect a Sputum Sample
PB120-10-05E French How to Collect a Sputum Sample
110-10-13  Utilization of Lipid Profile Testing
100-10-13A01 Semen Collection Brochure – English
100-10-13A01FR Semen Collection Brochure – French
INR Testing Service Change (January 2017)

Discipline Resources

Clinical Biochemistry and Genetics

Clinical Microbiology

Transfusion Medicine


Shared Health Diagnostic Services multi-disciplinary Laboratory Information Manual is the source of current and consistent laboratory references and values for Shared Health Diagnostic Services Winnipeg region labs. Phase Two of the LIM initiative will be to further expand the manual to apply to all labs within the provincial system, beginning with the integration of the Westman Regional Laboratory data into the LIM.

Laboratory Information Manual

Cadham Provincial Laboratory is not part of Shared Health Diagnostic Services. Please refer to their website for information.

Cadham Provincial Laboratory