Get Shodair Dna Laboratory Test Request Form

This guide provides a comprehensive walkthrough on completing the SHODAIR DNA laboratory test request form online. Whether you are a patient, a healthcare provider, or a supporting individual, this step-by-step guide will help you navigate through each section of the form smoothly and accurately.

Follow the steps to successfully complete the SHODAIR DNA laboratory test request form

1. Click 'Get Form' button to obtain the form and open it in the online editor.
2. Enter patient information in the designated fields. This includes the last name, first name, date of birth (DOB), and sex. Ensure that all details are accurate to avoid any delays in processing.
3. Fill out the referring physician or health professional’s information. Provide the name, address, city, state, zip code, and contact details (telephone and fax). This information is crucial for correct submission and communication.
4. Complete the referring institution, clinic, or laboratory section by including the name of the institution where the request is being made.
5. Specify additional reports by entering the name of the person or department to whom reports should be sent, ensuring they receive the necessary information.
6. Obtain the physician's signature and date, which is a requirement for billing through Medicare or Medicaid.
7. Fill in the billing information section. Choose the method of payment (referring institution, insurance, self-pay, or inpatient) and complete the applicable fields based on the selected option.
8. Clearly indicate the reason for analysis and specify the symptoms or possible diagnosis, including relevant ICD-9 codes, if applicable.
9. Select specimen type. Check the appropriate box based on the specimen being sent for analysis. Please also note any transport recommendations if needed.
10. Check the requested tests and ensure any additional requirements or specifications are noted. Make sure the correct tests are selected based on the needs.
11. Review the entire form for accuracy and completeness before finalizing. Once confirmed, proceed to save the changes, download, print, or share the form as necessary.

Complete your SHODAIR DNA laboratory test request form online today to ensure efficient processing!