Get Pathology Request Form

This guide provides comprehensive instructions on how to accurately complete the Pathology Request Form online. By following the outlined steps, you can ensure that all necessary information is provided clearly and effectively.

Follow the steps to successfully complete the Pathology Request Form.

1. Click the ‘Get Form’ button to obtain the form and open it in your web browser.
2. Begin filling out the applicant details section. Enter your UHG/HSN ID number, given name, surname, address, state, postcode, and date of birth. Ensure all information is accurate and up-to-date.
3. In the pathology data entry section, indicate the doctor to whom a duplicate copy of the results should be sent by entering the doctor's name and fax number.
4. Select the tests requested for life insurance purposes by marking an X in the corresponding boxes next to each test. Include any additional tests required under 'Other'.
5. Complete the collector's instructions, noting any fasting requirements and the number of hours of fasting, if applicable.
6. The collector must sign and certify the identification of the applicant, recording the type of identification provided. Ensure the collection time and signature of the examiner are included.
7. Review the privacy statement and the patient/insurance applicant’s declaration. The applicant must sign and date the form to confirm consent for the analysis of the specimens.
8. Once all sections are completed and reviewed, you can save changes, download, print, or share the form.

Complete the Pathology Request Form online now to ensure your results are processed efficiently.