Project Description

Requisition Forms

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Importing Requisitions

To import a form that has been created, first a new supplier needs to be created.

1. Go to Organization/External Providers and create a New External Provider.
2. Put the name of the requisition as the Full Name, change the Type to Suppliers, and change the Specialty to listed Profile Supplier Type below (Must be same as original).
3. Click OK to save the Supplier and reopen the window.
4. Go to the Order Format view, and select Scanned Form under Print Format.
5. Click on the Import order format for current provider button on the small toolbar.
6. Navigate to the JAFFA (.jfa) file containing the requisition to be imported and click OK.
7. Click OK to save the External Provider with the form. The form can now be used in the applicable view.

For instructions on building your own requisitions, see the Requisition Builder documentation on the Self Service Centre.

British Columbia

Provincial
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Application for Psychiatric Medication Coverage

Profile Supplier Type: Any
Submitted by Christina at Riverside Clinic, Trail


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Bone Densitometry - BC Standard

Profile Supplier Type: Radiology


Version 2 - Updated July 2014


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Canadian Blood Services Perinatal Screen Request

Profile Supplier Type: Pathology


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Gynecological Cytology, BC Cancer Agency

Profile Supplier Type: Pathology


Version 2 - Updated September 2013


Download
Prenatal Genetic Screening - Prenatal Biochemistry Laboratory

Profile Supplier Type: Pathology


Download
PHSA Serology Screening v2

Profile Supplier Type: Pathology


Version 2 - Updated July 2014


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Sleep Apnea Referral - Coastal Sleep

Profile Supplier Type: Other


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VitalAire Sleep Care

Profile Supplier Type: Respiratory Physiology
Submitted by Darla Wiebe at Rutland Medical Associates, Kelowna


Download
Fraser Health
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Bone Densitometry - Fraser Health

Profile Supplier Type: Radiology


Version 2 - Updated August 2014


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Breast Imaging - Fraser Health

Profile Supplier Type: Radiology


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Echocardiogram - Fraser Health

Profile Supplier Type: Any


Download
Magnetic Resonance - Fraser Health

Profile Supplier Type: Radiology


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Medical Imaging - Fraser Health

Profile Supplier Type: Radiology


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Nuclear Medicine - Fraser Health

Profile Supplier Type: Radiology


Download
Pulmonary Diagnostics Referral - Fraser Health Respiratory Services

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Sleep Apnea Referral - Coastal Sleep

Profile Supplier Type: Other


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South Fraser Cardiology

Profile Supplier Type: Radiology


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Interior Health
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Anatomic Pathology Consult - Interior Health

Profile Supplier Type: Any


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Bone Density - Interior Health

Profile Supplier Type: Radiology


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Cardiology Services, Kelowna General Hospital

Profile Supplier Type: Cardiology
Submitted by Darla Wiebe at Rutland Medical Associates, Kelowna


Download
Cardiopulmonary Services - Vernon Jubilee Hospital

Profile Supplier Type: Radiology


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Computed Tomography - Central Okanagan

Profile Supplier Type: Radiology


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CT - Interior Health

Profile Supplier Type: Radiology


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Diagnostic Imaging - Central Okanagan

Profile Supplier Type: Radiology


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Diagnostic Imaging – Interior Health Authority

Profile Supplier Type: Radiology


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Flexible Sigmoidoscopy - Kelowna General Hospital

Profile Supplier Type: Gastroenterology
Submitted by Darla Wiebe at Rutland Medical Associates, Kelowna


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Lakeside Medical Supplies

Profile Supplier Type: Radiology


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MedPro Respiratory Care

Profile Supplier Type: Respiratory Physiology
Submitted by Darla Wiebe at Rutland Medical Associates, Kelowna


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Outpatient and Home Health Dietitian (RD) Referrals, Kootenay Boundary Region

Profile Supplier Type: Any
Submitted by Christina at Riverside Clinic, Trail


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Pulmonary Diagnostics – Vernon Jubilee Hospital

Profile Supplier Type: Radiology


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Respiratory Homecare Solutions Sleep Apnea & Oxygen Therapy

Profile Supplier Type: Respiratory Physiology
Submitted by Darla Wiebe at Rutland Medical Associates, Kelowna


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Respiratory Services, Kelowna General Hospital

Profile Supplier Type: Respiratory Physiology
Submitted by Darla Wiebe at Rutland Medical Associates, Kelowna


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Teleneurology Referral Request, UBC Kelowna

Profile Supplier Type: Any
Submitted by Christina at Riverside Clinic, Trail


Download
Northern Health
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Computed Tomography - Kitimat General Hospital

Profile Supplier Type: Radiology


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Computed Tomography - Northeast Northern Health

Profile Supplier Type: Radiology


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Diagnostic Imaging - Fort St. John

Profile Supplier Type: Radiology


Download

Electrocardiogram - Fort St. John

Profile Supplier Type: Any


Download
X-Ray - Kitimat General Hospital

Profile Supplier Type: Radiology


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X-Ray and Ultrasound - Bulkley Valley District Hospital

Profile Supplier Type: Radiology


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X-Ray, Ultrasound, and Nuclear Medicine - Northern Health

Profile Supplier Type: Radiology


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Vancouver Coastal Health
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Bone Density - Greig Associates

Profile Supplier Type: Radiology


Version 2 - Updated November 2015


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Bone Mineral Densitometry, Downtown Radiology

Profile Supplier Type: Radiology
Submitted by Mai Le at Copeman Healthcare


Download
Breast Imaging, West Coast Medical Imaging, Vancouver

Profile Supplier Type: Radiology


Download
Cancer Genetics - BC Cancer Agency

Profile Supplier Type: Pathology


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Clinical Sleep Solutions

Profile Supplier Type: Radiology


Download
Computed Tomography - Providence Healthcare

Profile Supplier Type: Radiology


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Computed Tomography - Whistler Health Care

Profile Supplier Type: Radiology


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Echocardiogram - St. Paul's Hospital

Profile Supplier Type: Any


Download
Electroencephalogram - Lions Gate Hospital

Profile Supplier Type: Any


Download
Hematological Neoplasia - Cytogenetics Laboratory

Profile Supplier Type: Any


Download
Imaging Services - Lions Gate Hospital

Profile Supplier Type: Radiology


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Mammogram - Greig Associates

Profile Supplier Type: Radiology


Version 2 - Updated November 2015


Download
Molecular Genetics Laboratory - C&W Health Centre

Profile Supplier Type: Pathology


Download
MRI, West Coast Medical Imaging, Vancouver & Victoria

Profile Supplier Type: Radiology


Download
Orthopaedic Specialist Referral Form - Richmond Division of Family Practice

Profile Supplier Type: Radiology


Download
PET or CT Scan - BC Cancer Agency

Profile Supplier Type: Radiology


Download
Radiology - BC Children's Hospital

Profile Supplier Type: Radiology


Download
Radiology - Squamish General Hospital

Profile Supplier Type: Radiology


Download
Sleep Apnea Referral - Coastal Sleep

Profile Supplier Type: Other


Download
Ultrasound - Greig Associates

Profile Supplier Type: Radiology


Version 2 - Updated November 2015


Download
Ultrasound - BC Women's Hospital

Profile Supplier Type: Radiology


Download
Ultrasound - North Shore Medical Imaging

Profile Supplier Type: Radiology


Download
Ultrasound - North Shore X-Ray

Profile Supplier Type: Radiology


Version 2 - Updated January 2014


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Ultrasound - Squamish General Hospital

Profile Supplier Type: Radiology


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X-ray- Greig Associates

Profile Supplier Type: Radiology


Version 2 - Updated November 2015


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X-ray and Ultrasound, West Coast Medical Imaging, Vancouver

Profile Supplier Type: Radiology


Version 2 - Updated November 2016


Download
Vancouver Island Health
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Bone Densitometry, West Coast Medical Imaging, Victoria

Profile Supplier Type: Radiology


Download
Breast Imaging, West Coast Medical Imaging, Victoria

Profile Supplier Type: Radiology


Download
MRI, West Coast Medical Imaging, Vancouver & Victoria

Profile Supplier Type: Radiology


Download
VIHA X-ray Outpatient

Profile Supplier Type: Radiology


Download
X-ray and Ultrasound, West Coast Medical Imaging, Victoria

Profile Supplier Type: Radiology


Version 2 - Updated September 2015


Download

New Brunswick

None available

Ontario

None available

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Support: 1-800-708-6442 - Email: support@intrahealth.com