Getting blood work in BC: requisitions, booking, fasting, costs and results

Step one: get a requisition

In BC, blood work needs a requisition signed by a doctor, nurse practitioner or other provider. LifeLabs states it only accepts and processes signed requisitions, and Vancouver Coastal Health (VCH) and Fraser Health outpatient labs also test only with a requisition. ^[1][2][3] BC Children's Hospital lab also says it does not accept requisitions from naturopaths. ^[4]

If you have no family doctor, a walk-in or virtual clinic doctor can assess you and write a requisition if testing is needed.

Where to go: LifeLabs or a hospital outpatient lab

In Metro Vancouver there are two main options: private community labs such as LifeLabs patient service centres, and outpatient labs in health authority hospitals. Both need a requisition, and most tests are paid by MSP.

LifeLabs notes that mornings tend to be busier because many people come in fasting. ^[1] Health authority labs do not offer every test at every site at all times, some tests need an appointment, and hours are listed on each lab's page. ^[2][3]

Fasting and other preparation

• Whether and how long to fast depends on the requisition and your provider's instructions. Fraser Health lists glucose tolerance, lipids and amino acids as fasting tests, and recommends fasting for iron and bile acids. ^[3]
• BC Children's Hospital says that if the requisition gives no time, fast for 10 to 12 hours, with only water and medications allowed. ^[4]
• Ask the ordering provider whether to hold any regular medication; don't stop medicines on your own.
• LifeLabs posts test-specific preparation instructions you can check in advance. ^[5]

What MSP covers, and paying without a requisition

Most routine tests ordered by a provider are paid by MSP. Some are not, and your provider will usually tell you about a fee in advance; if your health card is expired or forgotten, you may be asked to pay. ^[1][5] People without MSP or other provincial coverage, such as newcomers still in the wait period, pay for all tests. ^[3]

You cannot walk into a collection site and pay for a test without a requisition. Most tests sold in the LifeLabs online store still need a provider's signed requisition, though a few come pre-signed. Buyers must be 18 or older and pay in advance, results go to the provider who signed, and some results also appear in MyCareCompass. ^[6]

Where to see results

• Health Gateway: the province's personal health record site, logged into with the BC Services Card app. Most blood results appear about 2-3 days after the test and pathology takes weeks; results from 2020 on are shown, and records can take up to 4 days to load after you first sign up. ^[7][8]
• MyCareCompass: LifeLabs' free results portal, which also shows outpatient results from VCH, Providence, Fraser Health and BC Children's and Women's. ^[9]
• "Out of range" does not necessarily mean something is wrong; a provider interprets results with your history. Ask the ordering provider, or call HealthLink BC at 8-1-1. ^[8]

Blood tests for children

Children also need a requisition. At BC Children's Hospital, routine blood draws are walk-in only, Monday to Friday 7 a.m. to 5:45 p.m., closed weekends and statutory holidays; appointments are only for sweat tests and oral glucose tolerance tests, at 604-875-2139, option 2. ^[4]

Online access has age limits. Health Gateway lets you add dependents 11 and under, but currently shows only their immunization records, not lab results; children 12 and over need their own account. ^[10] BC Children's sends results to the ordering doctor, and copies for children under 16 require a written request. ^[4] The simplest route for parents is to ask the ordering doctor.

No family doctor: who follows up?

Under the CPSBC practice standard, following up results is ultimately the responsibility of the ordering doctor unless another doctor or nurse practitioner has agreed to take it on. A patient who has not named a family doctor is assumed to be getting primary care from that clinic. If a critical result comes to any doctor's attention, that doctor must take reasonable steps to make sure it is acted on. ^[11]

In practice, keep the clinic's contact details, call if you have not heard back when expected, and return to the same clinic for follow-up when you can.