Get Laboratory Requisition Form - Ann & Robert H. Lurie Children's ... - Luriechildrens

Filling out the Laboratory Requisition Form for Ann & Robert H. Lurie Children's Hospital is an essential step in facilitating effective communications between healthcare providers and the laboratory. This guide provides clear and structured instructions to help users accurately complete the form online.

Follow the steps to fill out the Laboratory Requisition Form effectively.

1. Press the ‘Get Form’ button to access the Laboratory Requisition Form and open it in your preferred editor.
2. Begin by entering the patient information. Fill in the fields for the patient's full name, date of birth, and medical record number (MR#). Ensure that all details are accurate, as they are crucial for identifying the patient.
3. Select the appropriate specimen type from the options provided, such as blood, urine, or other samples. Specify if the collection is fasting or random as necessary.
4. Enter the collection date and time. This is critical for the laboratory to ensure the integrity of the specimen. Indicate the person who collected the specimen in the designated field.
5. Identify the ordering provider's information, including the provider's name and signature. This field may require confirmation of the specific tests ordered.
6. Check the boxes for any required tests, add-on tests, or special requests. Ensure that the correct test codes and tube types are selected as indicated in the table.
7. Indicate where to fax the results. Fill in the contact information for critical results separately to ensure swift communication.
8. Once all fields are filled, review the document for completeness and accuracy. When satisfied, save your changes, download the form for your records, or print it as needed to finalize the requisition.

Complete your Laboratory Requisition Form online to streamline the process and ensure efficient laboratory testing.