Get Clinical Test Requisition Form - Ct.gov - Ct

This guide provides comprehensive instructions for users on how to complete the Clinical Test Requisition Form required for laboratory testing. By following these steps, users can ensure that they fill out the form accurately and efficiently.

Follow the steps to successfully complete the Clinical Test Requisition Form.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Complete the 'Name and Address of Authorized Submitter' section, filling in the client’s name, address, attention line, and Horizon Profile number, ensuring all required fields are completed.
3. In the 'Patient Information' section, provide the patient's name, date of birth, address, and selection of gender. Record any required patient identifiers.
4. Fill in the 'Authorized Contact' information, including the name and phone number of the person who can be contacted regarding this requisition.
5. Provide the 'Date Collected' and 'Time Collected' information, and select whether the time is in the AM or PM.
6. Choose the 'Specimen Source/Type' by checking the appropriate box that describes the specimen being collected.
7. In the 'Select Testing Requested' section, check all tests that apply. Ensure that you have all necessary supporting information for the tests chosen.
8. Complete any additional sections that may apply, such as 'Race/Ethnicity Information Required for Blood Lead' and specify any reference tests required.
9. Review all information filled in the form to ensure it is accurate and complete. Check that all required fields, denoted with an asterisk (*), are appropriately filled.
10. Once all information has been entered and verified, save changes, download, print, or share the form as needed.

Complete your Clinical Test Requisition Form online today for efficient laboratory processing.