Get Printable Lab Requisition Form

Filling out the Printable Lab Requisition Form accurately is essential for ensuring efficient processing of laboratory specimens. This guide provides clear and detailed instructions to help users complete the form online, ensuring that all necessary information is captured for optimal patient care.

Follow the steps to fill out the Printable Lab Requisition Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Begin by filling out the top portion of the form with patient information. This includes entering the patient's name (last, first, and middle initial), date of birth, address, and phone number, ensuring accuracy for effective processing.
3. Provide the patient's Social Security number or medical record number, and ensure to complete the ordering physician's name and the patient chart number for proper tracking.
4. Indicate whether the test is urgent by selecting STAT or ASAP testing options, and fill in the collection date and time along with the collector's initials.
5. In the section for insurance and billing information, check the appropriate box for billing preferences and fill out details such as the guarantor's name, relationship to the patient, and other required insurance information.
6. List any diagnosis codes or reasons for testing in the designated area, ensuring to match these codes with the tests requested at the bottom of the requisition.
7. For the request of tests, select the boxes next to each required test and clearly write in any additional test names that are not preprinted on the form.
8. If applicable, make sure to indicate any special instructions or source information in the provided area without adding tests in this space.
9. Ensure all sections are completed and review the form for accuracy and clarity. It is critical that the information is legible, so bear down while writing if filling the form out in ink.
10. Once all fields are complete and double-checked, save your changes, then download and print the form for submission. Alternatively, you may share the completed form electronically if necessary.

Complete your documents online today to facilitate smooth specimen processing and optimal patient care.