Secure Upload Portal

Submit your completed Laboratory Services Form

Please use the below fields to submit your completed Laboratory Services form (e.g. Operator Payment Administration form; Application Moratorium Exemption Request; Application Form; Notification of Change Form, etc.)

Ensure your form is complete and appropriately authorized prior to submitting. Only complete and authorized forms can be processed.

For clarification regarding the submission of a form, please contact Laboratory Services at labfacilities@phsa.ca

To submit an authorized form:

Print/scan the completed form and save a digital copy to your computer
Complete all information fields below
Click [Choose File] and locate the scanned form on your computer
Once the file has been uploaded, click [Submit Form]

To report any issues with the secure upload tool, please send an email to labfacilities@phsa.ca

*First Name

*Last Name

*Email Address

user@domain.ca

*Phone Number

250-123-4567

*Facility Name

*Attach completed forms

(PDF, JPG, PNG, GIF, BMP. Click to add file. Multiple files can be attached one at a time.)

Warning: Do not upload patient demographic data.

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