Get Blood Test Requisition Form

Filling out the Blood Test Requisition Form accurately is essential for ensuring that your medical testing is processed smoothly. This guide provides clear, step-by-step instructions to assist you in completing the form online with confidence.

Follow the steps to complete the Blood Test Requisition Form.

1. Click ‘Get Form’ button to obtain the form and open it in the document editor.
2. Begin with the 'Accession #' field. Enter the unique identification number assigned to this requisition to help track your tests.
3. Fill out the 'PHN / Healthcare Number' section with the patient's personal health number for verification purposes.
4. Provide the patient's legal name, ensuring you complete the fields for 'Last', 'First', and 'Initial' accurately.
5. Complete the 'Address', 'City', 'Prov.', and 'Postal Code' fields to ensure proper correspondence and location of the patient.
6. In the 'Patient Phone #' section, include a contact number where the patient can be reached.
7. Input the patient's date of birth in the specified format (DD/MM/YY) to verify their identity.
8. Indicate the 'Ordering Physician / Practitioner' name along with their 'Physician Code' and 'Ordering Address / Location' for referral connections.
9. Fill in the 'Date specimen collected' with the appropriate date in the DD/MM format and provide the collection time in a 24-hour format.
10. Specify the 'Specimen Event Type' by checking the appropriate boxes to indicate the type of specimen being submitted.
11. Complete the 'INDICATION' section by checking all relevant boxes, including any necessary specifications related to prenatal testing or other genetic concerns.
12. Conclude with any relevant family history details by answering questions about previously tested family members and providing the necessary pedigree documentation.
13. Finally, review all entries for accuracy. Once completed, users can save changes, download, print, or share the form as required.

Begin filling out your Blood Test Requisition Form online today to streamline your diagnostic process.