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Facility specimen collection request

FOR LTCH/RH USE ONLY. This form should only be used to request specimen (swab) pick up or drop off. Routine staff surveillance collection for LTCH/RH is done by the facility’s private couriers, not OPH. Please fill out all required fields. For any questions or concerns please contact IPAC at IPAC/ or 613-580-2424 ext 26325.

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