Get Norman Regional Laboratory Services (nrls) Request For Copia Deceased Patient Deactivation

Filling out the Norman Regional Laboratory Services (NRLS) Request For Copia Deceased Patient Deactivation form is a straightforward process. This guide provides step-by-step instructions to assist users in completing this online document efficiently and accurately.

Follow the steps to fill out the form successfully.

1. Click the ‘Get Form’ button to obtain the NRLS Request For Copia Deceased Patient Deactivation form and access it in the appropriate online editor.
2. Once the form is open, locate the section titled 'Completed by Practice.' Here, you will need to fill in the necessary details about the deceased patient.
3. In the designated fields, enter the last name and first name of the patient exactly as they appear on official records to ensure accuracy.
4. Next, provide the date of birth (DOB) of the patient in the specified format. This information is essential for the identification of the deceased patient.
5. In the 'Organization Name' section, input the name of the organization requesting the deactivation. Ensure this is the organization associated with the patient’s records.
6. The form requires a signature from a director or authorized individual. This signature confirms the request and authenticates the submission, so ensure to sign in the appropriate section.
7. After completing all required fields, review the form to ensure all information is correct and complete.
8. Once reviewed, save your changes and choose to download, print, or share the form as needed. Additionally, fax the completed form to 405-515-5069, Attn: Copia Admin.

We encourage you to complete and submit your document online for a smooth processing experience.