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Saskatoon Health Region COMMUNITY MOBILE PHLEBOTOMY REQUISITION To be used for Saskatoon and Area Residents Only Clinical Diagnosis: PHN #: Requesting Physician: Name: Date of Birth: Phone #: Address:.

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How to fill out the Phlebotomy Requisition online

The phlebotomy requisition is an important document used to request mobile blood collection services for individuals in the Saskatoon area. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently.

Follow the steps to complete the form successfully.

  1. Click ‘Get Form’ button to obtain the form and open it for editing.
  2. In the ‘Clinical Diagnosis’ field, clearly enter the patient's medical diagnosis. This section is crucial for the lab's understanding of the request.
  3. Provide the patient’s health number (PHN) in the designated box. This identifies the patient in the health system.
  4. Fill in the requesting physician's name to ensure that the request is linked to a healthcare provider.
  5. Enter the patient’s full name, date of birth, phone number, and address. Accurate personal information will prevent any processing delays.
  6. Indicate where additional reports should be sent by filling in the 'Additional Copies of Report to' section, along with the frequency of reports, selecting one of the available options.
  7. Check the appropriate box that indicates why the patient requires mobile service, using the options provided in the section about qualifying for mobile service.
  8. Obtain the physician's signature. This is a required step for processing the request.
  9. Once all fields are completed, verify the information for accuracy and completeness to avoid delays.
  10. After ensuring the information is correct, save any changes, download the document, print it, or share it as needed. Be sure to fax the completed requisition to 655-4021.

Complete your phlebotomy requisition online today to ensure timely processing of your request.

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Requisition refers to physician's order/doctor's order/lab order. A physician order is an authorization for you to have lab testing performed. It's similar to a doctor providing a prescription for medication. This step is needed because some states require that a licensed medical doctor authorize laboratory tests.

A requisition form must accompany each sample submitted to the laboratory. This requisition form must contain the proper information in order to process the specimen. The essential elements of the requisition form are: Patient's surname, first name, and middle initial.

Of the three veins in the antecubital area acceptable for venipuncture, the median cubital vein (in the middle) is the vein of choice for four reasons: 1) it's more stationary; 2) puncturing it is less painful to the patient; 3) it's usually closer to the surface of the skin; and 4) it isn't nestled among nerves or ...

Patient's surname, first name, and middle initial. Patient's ID number. Patient's date of birth and sex. Requesting physician's complete name. Source of specimen. ... Date and time of collection. Initials of phlebotomist. Indicating the test(s) requested.

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