Guide · Updated September 2026
What a lab requisition is, who is allowed to sign one, whether you can get blood work without one, what the tests cost if you have no OHIP, and how to get a requisition when you have no family doctor or no health card.
The short version. In Ontario you need a requisition signed by a physician, nurse practitioner or other authorized clinician before a community lab will draw your blood or run a test. The lab will not process a requisition without a signature. You do not need a family doctor: a walk-in clinic or a virtual doctor can order tests where they are clinically appropriate. If you have no OHIP, you pay both for the visit and for the lab tests themselves.
Key facts at a glance
In this guide
It is the order form a clinician fills in to request your lab tests. The Ontario Ministry of Health's standard form is called Laboratory Requisition – Requisitioning Physician / Practitioner, form number 4422-84.
The clinician marks the tests you need, such as a blood count, cholesterol or a urine test, adds their details and signs it. You then take it, or have it sent, to a licensed community lab such as LifeLabs or Dynacare, where the sample is collected.
The signature is what makes it valid. LifeLabs states that signed requisitions are mandatory and that it will only accept and process a signed requisition. A blank or self-completed form will not be accepted.
The Ministry's schedule also says that OHIP-insured community lab tests may only be ordered on the Minister-approved requisition form or through a clinician's electronic medical record system.
Physicians and nurse practitioners can order lab tests. A few other professions can order some tests. The College of Medical Laboratory Technologists of Ontario (CMLTO) lists who may order tests under Ontario Regulation 45/22:
| Professional | What they can order |
|---|---|
| Physicians (members of the CPSO) | Lab tests generally |
| Nurse practitioners (registered nurses in the extended class) | Lab tests generally |
| Dentists | Lab tests (listed without a test restriction) |
| Midwives, including Aboriginal midwives | Only the tests listed in Schedule 2 of the regulation |
| Naturopaths | Only the tests listed in Schedule 1 of the regulation |
| Pharmacists | COVID-19 tests only |
Source: College of Medical Laboratory Technologists of Ontario, About laboratory tests, read 16 September 2026.
Who orders the test also affects OHIP coverage. The Ministry of Health's schedule says lab claims are not insured when the test is ordered by anyone other than a physician, midwife or nurse practitioner. A test ordered by a naturopath, for example, is paid for by you even if you have OHIP.
Only for COVID-19. Under the same regulation, a pharmacist can order a lab test only for COVID-19. The Ontario College of Pharmacists (OCP) said on 29 April 2026 that pharmacy professionals can perform and collect specimens for a short list of point-of-care tests in the pharmacy itself: glucose, hemoglobin A1C, lipids, and prothrombin time (INR). They can also do COVID-19 point-of-care tests and pregnancy tests.
For anything beyond that, you need a physician or nurse practitioner. Our guide to what pharmacists can prescribe in Ontario explains the rest of what a pharmacist can do for you.
Not at LifeLabs. LifeLabs sells some tests directly to the public, but its terms state that direct services which are lab or diagnostic tests "require a signed requisition from an appropriate health care provider" before LifeLabs will process them.
So paying privately does not remove the need for a clinician. It only changes who pays for the test. A clinician still has to decide which tests make sense, sign the requisition, and review what comes back.
Feeling unwell right now? Blood work is not the right first step for severe or sudden symptoms such as chest pain, trouble breathing, heavy bleeding or confusion. Call 911 or go to the nearest emergency department.
From any physician who assesses you and decides the tests are clinically appropriate. Nothing requires the order to come from a family doctor.
| Option | With OHIP | Without OHIP |
|---|---|---|
| Walk-in clinic | Visit covered by OHIP | You pay the clinic's uninsured rate |
| Virtual clinic (OHIP-billing) | Visit covered by OHIP | Usually not available, or charged privately |
| Doctor Fran | Flat $82 visit | Flat $82 visit, no health card needed |
In every row, the lab tests are billed separately from the visit. See what you pay below.
If you have OHIP, use an OHIP-covered option first. It is free. Doctor Fran is built for people who can't: newcomers waiting for their OHIP card, international students, visitors to Ontario and anyone else without OHIP.
With OHIP, most tests a physician orders cost you nothing. Without OHIP, you pay the lab for every test. The Ministry of Health's Schedule of Benefits for Laboratory Services covers tests ordered by an authorized practitioner for patients enrolled in OHIP.
| Step | With OHIP | Without OHIP |
|---|---|---|
| The visit that orders the tests | Free at an OHIP-billing doctor; $82 at Doctor Fran | The clinic's private fee; $82 at Doctor Fran |
| The lab tests | Usually covered, except tests covered only for specific reasons (see below) | You pay the lab. The price depends on the tests and the lab |
| Reviewing the results | Free at an OHIP-billing doctor; $59 follow-up at Doctor Fran | $59 follow-up at Doctor Fran |
Sources: Ontario Ministry of Health, Schedule of Benefits for Laboratory Services (effective 3 March 2025); LifeLabs patient information, read 16 September 2026. Doctor Fran prices current as of September 2026.
Ask the lab before your sample is taken. LifeLabs says your doctor will usually tell you in advance if a test carries a fee, and that you will also be told about any fee, and the payment options, when you arrive at a Patient Service Centre.
LifeLabs also says that if you forget your health card or your card has expired, it may ask you for payment to process your tests. Check that your coverage is valid before you go.
If you have private or workplace health insurance, LifeLabs suggests contacting your insurer about coverage for tests OHIP doesn't pay for.
Some tests are covered only for particular medical reasons. Two common examples from the Ministry of Health's schedule:
LifeLabs stated in May 2022 that it cannot bill people with OHIP for tests that OHIP covers.
Bring the signed requisition, or send it ahead, and bring your ID and any health card. The two large community lab networks each have their own process.
Check each lab's website for preparation instructions such as fasting, and book ahead where the lab offers appointments.
The clinician who ordered the tests. The results go back to them, and they are responsible for acting on them.
The CPSO's Managing Tests policy (updated September 2019) requires physicians to record that every result they receive has been reviewed. When a result is clinically significant, the physician must always tell the patient, and must take clinically appropriate action on critical or clinically significant results.
At Doctor Fran, results are reviewed in a follow-up appointment that costs $59. The physician goes through what the results mean for you and what to do next, such as treatment, more tests or a referral. If a result needs urgent attention, the physician will contact you.
LifeLabs is clear that its online results are not medical advice: for advice about your results or your condition, it tells patients to ask their physician.
Yes, if a physician assesses you and decides the tests are clinically appropriate. Doctor Fran physicians are licensed in Ontario and assess patients by phone for a flat $82, with no health card needed. You then take the signed requisition to a community lab such as LifeLabs or Dynacare.
No. LifeLabs' terms say that even lab tests bought directly from LifeLabs need a signed requisition from an appropriate health care provider before they are processed. Physicians, nurse practitioners and dentists can order lab tests; midwives and naturopaths can order only certain specified tests.
No. Pharmacists can order COVID-19 tests only. The Ontario College of Pharmacists says they can perform a few point-of-care tests in the pharmacy, such as glucose, hemoglobin A1C, lipids and INR, but other lab tests must be ordered by a physician or nurse practitioner.
It depends on the tests and the lab, and you pay for each test. LifeLabs says you will be told about any fee, and the payment options, when you arrive at a Patient Service Centre. Ask for the price before your sample is taken. The visit that orders the tests is a separate cost.
Usually, when a physician, midwife or nurse practitioner orders it for a patient enrolled in OHIP. Some tests are covered only for specific reasons: vitamin D testing, for example, is covered only for conditions such as osteoporosis, rickets or renal disease. Tests ordered by other professionals, such as naturopaths, are not insured.
LifeLabs says a standing order requisition for repeat tests is valid until the expiry date set by the ordering clinician, up to a maximum of six months. If your tests are overdue or the requisition has expired, ask the clinician who ordered them for a new one.
No. LifeLabs says that in Ontario it does not accept forms issued by hospitals, and those tests must be completed by the hospital that issued the requisition.
The clinician who ordered the tests. The CPSO requires physicians to review every result they receive and to tell patients about clinically significant ones. At Doctor Fran, a physician reviews your results with you in a follow-up appointment that costs $59.
Related guides
The requisition, coverage and lab rules on this page were read on the Ontario Ministry of Health's Schedule of Benefits for Laboratory Services, the College of Medical Laboratory Technologists of Ontario, the Ontario College of Pharmacists, the CPSO, LifeLabs and Dynacare on 16 September 2026. Lab fees and OHIP coverage can change; check with the lab before your test. This page is general information, not medical advice. In an emergency, call 911.
Speak to a physician licensed in Ontario by phone. If tests are clinically appropriate, they can order them during the flat $82 visit, with no health card needed.
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