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S Court Olson Pavilion 8-333 Chicago, Illinois 60611 Warren Tourtellotte, M.D., Ph.D., Director Lin Li, M.D., Associate Director Donna Emge, HT-ASCP, Manager Date. Cancer Center Member Yes No Chart String No. Expiration PI-Name Requester Phone.

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Laboratory requisitions must include doctor's name; patient's name, age, date of birth, and identification number; tests to be performed; and date and time for specimen collection.

When blood, urine, or tissue is sent to a lab from a doctor's office a test requisition form is required. The patient demographics, ordering physician, insurance information and what test should be performed will be on this form. Test requisition forms normally include barcode labels along with readable numbers.

The label must contain the following legible information: Patient name. Patient medical record number, with check digit. Patient location. Collection date and time. Specimen type and/or source. Test required (note any special handling required) Ordering physician.

Requisition forms typically include the name of the person making the request, the date of the request, items requested, the delivery date, the delivery location, and the department responsible for fulfilling the request.

Laboratory request forms provide information about the laboratory test being requested for. They carry demographic data and other information such as location of patient, laboratory number, doctor's name, signature of the doctor, telephone number of the requesting doctor.

Laboratory requisitions must include doctor's name; patient's name, age, date of birth, and identification number; tests to be performed; and date and time for specimen collection.

A Laboratory Request Form or LRF refers to the idea of that document that works as clear communication of the required laboratory needs....5 Steps to Make Laboratory Request Form Step 1: Doc File. ... Step 2: Recipient Details. ... Step 3: Request Details. ... Step 4: Purpose. ... Step 5: Driver Details.

The Lab Order Form allows you order testing on patients' bodily fluid or tissue to obtain information about their health.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232