Check your test result status

1
Patient Name* This field is required.
First Name
Last Name
2
Patient Date of Birth* This field is required.Enter Patient date of birth in the following format: DD/MM/YYYY
Enter patient date of birth
3
Private E-mail* This field is required.This email will be used to communicate your test result status
example@example.com
Confirm Email
4
Do you have a Provincial Health Card?* This field is required.
YesNo
5
Which province is your health card from?* This field is required.
Ontario
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Prince Edward Island
Quebec
Saskatchewan
6
Enter your Ontario health card number* This field is required.format: 9999999999-aa
7
Enter your British Columbia health card number* This field is required.
8
Enter your ALBERTA health card number* This field is required.Format: 99999-99999
9
Enter your Manitoba health card number* This field is required.
10
Enter your New Brunswick health card number* This field is required.
11
Enter your Newfoundland and Labrador health card number* This field is required.
12
Enter your Nova Scotia health card number* This field is required.
13
Enter your Prince Edward Island health card number* This field is required.
14
Enter your Saskatchewan health card number* This field is required.
15
Private Phone Number* This field is required.
16
Select a test type* This field is required.
Blood
Urine
Biopsy
PAP Test
Swab
Stool
X-Ray
Ultrasound
Specialized Test
17
Select a Blood Test* This field is required.
Any Blood test report
Alk. Phosphatase
ALT
Any Immunology
Bilirubin
Biochemistry
Blood Culture
CBC (Complete Blood Count)
CK
Creatinine
Ferritin
Glucose
HbA1C
Hematology
Hepatitis A
Hepatitis B
Hepatitis C
INR (Prothrombin Time)
Lipid (Cholesterol)
Measles
Mumps
Pregnancy Test (Blood)
Prenatal Antibody
Rubella
Sodium/Potassium/Chloride
STD-Any STD tests
STD-Chlamydia (Blood)
STD-Gonorrhea (Blood)
STD-HIV (Blood)
STD-Other
STD-Syphilis (Blood)
TSH
Uric Acid
Varicella/Chicken Pox
Viral Hepatitis
Vitamin B12
Other Blood Test
18
Select a Urine Test
STD-Chlamydia (Urine)
STD-Gonorrhea (Urine)
Urine Bacterial Culture
Urinalysis (Chemical)
Urine Pregnancy
Albumin/Creatine Ratio (Urine)
Other Urine Test
19
Select a Swab Test
Any Swab test
Cervical
Fungal
Rectal
Sputum
STD Test (Swab)
Throat
Vaginal
Wound Culture
Other Swab test
20
Select a Stool Test
Stool Ova & Parasite
Stool culture
Stool Pinworm Test
Fecal Occult Blood Test (FOBT)
Colon Cancer Check (CCC)
Other Stool Test
21
Select X-Ray Testing Location* This field is required.
Done On-Site
Done at Outside Facility
22
Select Ultrasound Location* This field is required.
Done On-Site
Done at Outside Facility
23
Specialized Tests* This field is required.Done at an Outside Facility such as Hospital
MRI
CT
Mammogram
Biopsy
Sleep Study
Other
24
When did you do this test?* This field is required.If you do not remember the exact date, please enter an approximate time (i.e 1 week ago, 1 month ego etc.)
25
Type the name of test report that you are looking forIf the test report that you are looking for is not a part of previous list, specify the name of test you are looking for
Should be Empty: