Ultrasound and blood collection services (blood collection is performed simply on the tip of your finger) are offered to you in over 20 centres across Quebec. To make an appointment in the centre nearest you, complete the following form.
Note: You must obtain a prescription from your doctor for this test.
* Mandatory field
Name *
Address *
City *
Tel. (home) *
Tel. (office)
Cellular
E-mail
Name of your physician *
Name of your physician’s clinic:
Enter the first day of your last menstrual period::
Enter the number of days of your menstrual cycle: 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60