Lexander R. Judkins, MD Department of Pathology & Laboratory Medicine Pathologist in-Chief and Laboratory Director Phone: 323.361.2423, 877.543.9522 Fax: 323.361.6157 CLIA Number: 05D2097680 CAP Number: 9277593 California State License CLF260 ONCOKIDS TEST REQUISITION All information must be completed before sample can be processed. REPORTING INFORMATION PATIENT INFORMATION , Last Name First Name DOB (MM/DD/YYYY):.

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How to fill out the CA CHLA OncoKids Test Requisition online

Filling out the CA CHLA OncoKids Test Requisition online is essential for ensuring accurate processing of tests. This guide will provide you with clear, step-by-step instructions to help you complete the requisition form effectively.

Follow the steps to complete the OncoKids Test Requisition form.

  1. Click ‘Get Form’ button to obtain the document and open it in your editing interface.
  2. Complete the reporting information section, which may include the date, hospital, and contact details. Ensure accuracy to prevent any processing delays.
  3. Fill out the patient information fields, including last name, first name, date of birth, gender, and ancestry. Pay attention to each section to ensure no information is missed.
  4. Provide clinical information by entering the hospital or laboratory name, contact person's name, address, city, state, zip code, phone, fax, and email. This helps maintain clear communication regarding test results.
  5. In the billing information section, input details necessary for processing bills, such as the referring institution’s account number and contact details.
  6. Document sample information, including the date and time of collection, who collected the sample, and specimen ID. Choose the sample type from the options provided.
  7. Specify the test order, ensuring to select the appropriate tests required, and note any specific conditions, such as tumor percentage in the sample.
  8. Review all sections of the form for accuracy and completeness. Make necessary edits to avoid complications during the testing process.
  9. Once completed, save your changes. You may choose to download, print, or share the form as needed.

Complete your documents online to ensure efficient processing.

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