Get the free Semen Analysis Requisition - Alberta Health Services

SEMEN ANALYSIS REQUISITION Laboratory Client Services: (603) 2277050Fax: (603) 2287345Ordering Provider (print):Patient name:Address:Address: Fax #:Phone #:City:State:Mail copy to:DOB:Address:Partner

How to fill out semen analysis requisition

How to fill out semen analysis requisition

1. Obtain a semen analysis requisition form from a healthcare provider or laboratory.
2. Provide your personal information, such as your name, date of birth, and contact information, in the specified fields.
3. Follow any specific instructions provided on the requisition form, such as avoiding ejaculation for a certain period of time before the test.
4. Fill in the date and time of collection for the semen specimen.
5. Indicate whether the sample was collected through masturbation or other methods.
6. Provide any relevant medical history or medications that may affect the results.
7. Follow any additional instructions for collection, preservation, and transportation of the specimen.
8. Review the completed requisition form for accuracy and legibility.
9. Submit the filled-out semen analysis requisition form to the designated healthcare provider or laboratory for testing.

Who needs semen analysis requisition?

1. Semen analysis requisition is typically needed by individuals who are experiencing fertility issues or planning to undergo assisted reproductive techniques.
2. It may also be requested by healthcare providers to assess potential male infertility factors or as part of a routine fertility evaluation.

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