Get Test Request Form Colorado Genetics Laboratory - Children's ... - Childrenscolorado

Completing the test request form for the Colorado Genetics Laboratory is a straightforward process that ensures you provide all necessary information for specimen processing. This guide outlines each step in detail to assist you in filling out the form accurately online.

Follow the steps to complete the request form successfully.

1. Click 'Get Form' button to access the test request form and open it in your document editor.
2. Begin by entering patient information, including the patient's last name, first name, middle initial, and date of birth in the designated fields.
3. If applicable, include the hospital or ID number provided to the patient.
4. Indicate whether the patient is an inpatient or outpatient by checking the appropriate box.
5. Fill in the referring physician's details, including their name and facility, along with the associated addresses and telephone numbers.
6. Select the appropriate billing information: patient, insurance, hospital, or physician/clinic, and provide any required details on the reverse side of the form.
7. Document any signs, symptoms, or narrative diagnoses, and provide the required ICD9 codes, ensuring to avoid the use of 'rule out'.
8. Obtain the physician's signature to authorize the form.
9. For specimen collection, enter the date collected and if applicable, document gestation and fetal sex.
10. Choose the specimen type by checking the relevant box, and indicate the studies requested.
11. For cancer specimens, select the appropriate type and studies requested, including any required details.
12. For constitutional blood specimens, specify the type and requested studies.
13. Finally, save any changes made to the form, and you can download, print, or share the completed request form as needed.

Complete your documents online today to ensure a smooth testing process.