Get Urology Requisition Form Blu-rq001 Newdraft 120313 Version B

Filling out the Urology Requisition Form BLU-RQ001 NEWDRAFT 120313 Version B online is essential for accurate patient information and effective communication within urology services. This guide provides clear and detailed instructions to help users navigate the form seamlessly.

Follow the steps to accurately complete the form online:

1. Press the ‘Get Form’ button to access the Urology Requisition Form BLU-RQ001 NEWDRAFT 120313 Version B and view it in your preferred online format.
2. Begin by entering the histology ICD-9 code and the number of vials submitted in the designated fields.
3. Indicate if a saturation biopsy was performed and provide the collection date along with the PSA level, ensuring all required fields are filled.
4. For previous biopsy history, select appropriate options including 'None', 'Benign', 'Suspicious/ASAP', 'HGPIN', or 'Malignant'. Ensure to indicate previous therapy if applicable.
5. In the physician information section, complete all relevant details including the physician’s signature and any requested duplicate report information.
6. Proceed to fill in patient information accurately, including the last name, first name, middle initial, address, and contact details.
7. Ensure all billing information is complete by indicating primary and secondary insurance details, if applicable.
8. Review all sections and fields for accuracy; once completed, save your changes, download, print, or share the form as necessary.

Complete your documents online efficiently and accurately today!