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Get Ui Health Care Microbiology Laboratory Requisition 2019
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How to fill out the UI Health Care Microbiology Laboratory Requisition online
Completing the UI Health Care Microbiology Laboratory Requisition online is essential for streamlined specimen testing and accurate reporting of results. This guide will walk you through each section of the requisition form, ensuring that you provide all necessary information correctly.
Follow the steps to successfully complete the requisition form.
- Click the ‘Get Form’ button to obtain the form and access it for completion.
- In Part A, fill in the patient information. Enter the patient’s last name, first name, street address, city, state, zip code, phone number, fax number, date of birth, and select the gender.
- In Part B, provide the referring institution's details. Fill out the referring institution's street address, city, state, zip code, phone number, fax number, the name of the referring physician, and the referring physician's phone number.
- In Part C, input the specimen information. Specify the specimen collection date and time. List all required ICD-10 codes, and detail the specimen type. Indicate if blood, body fluid, urine, stool, or tissue is used, and specify the collection method.
- Indicate the tests requested by checking the appropriate boxes under the cultures section. You may also include any additional information regarding specimen specifics or clinical history.
- In Part D, indicate how the billing should be addressed. Choose either the referring institution or the patient’s insurance. Complete all billing information required, including the insured by details, claims address, policy ID, and subscriber information.
- Review all entries for accuracy. Ensure all fields are filled out correctly to avoid processing delays. Save your changes, then download, print, or share the completed requisition as needed.
Begin filling out your document online now to ensure timely processing of specimens.
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