Winnipeg, MB - Perinatal Requisitions

REQUISITIONS/FORMS

Maternal Routine Testing (ABO/Rh Typing/Antibody Screen)
Request for Perinatal Testing (PDF)
(Electronic Fillable Form)

Father's Rh Typing (when maternal Rh is negative) - when requested by Canadian Blood Services
Request for Perinatal Testing (PDF)
(Electronic Fillable Form)

Cord/Neonate  Testing (ABO/Rh/DAT - HDFN Investigation)
Request for Cord - Neonate Blood Testing Requisition (MB) (PDF)

Post Natal Testing - Rh Negative Mothers
Request for Perinatal Testing (PDF)
(Electronic Fillable Form)

Fetal Bleed Screening Test (FMH Rapid Screen)
Request for Perinatal Testing (PDF)
(Electronic Fillable Form)

Kleihauer-Betke - Quantitative Test for Fetal Bleed
Request for Perinatal Testing (PDF)
(Electronic Fillable Form)

Fetal Genotyping from Maternal Plasma Requisitions
Testing is only available for Canadian residents. Please contact International Blood Group Reference Laboratory for testing inquires.

International Blood Group Reference Laboratory Requisition DS (PDF) (Use the link to download the Fetal Genotyping from Maternal Blood form FRM4674)

Request for Perinatal Testing (PDF)
(Electronic Fillable Form)

Guidance for Completion of International Blood Group Laboratory Requisition

Fetal Genotyping on Maternal Plasma Updates (PDF)

Fetal Genotyping from Maternal Plasma Consent
Consent for Release of Neonatal Test Results (PDF)

Fetal Genotyping from Maternal Plasma Instructions
Fetal Genotyping on Maternal Plasma Collection Site Instructions (PDF)
Fetal Genotyping on Maternal Plasma Maternal Fetal Medicine Instructions (PDF)