Get Clarity Clinical Laboratory Toxicology Test Requisition

This guide provides clear, step-by-step instructions on how to complete the Clarity Clinical Laboratory Toxicology Test Requisition form online. Ensuring accurate information will facilitate efficient processing and testing.

Follow the steps to fill out the requisition form accurately

1. Click ‘Get Form’ button to access the Toxicology Test Requisition form and open it for editing.
2. Fill in the specimen information section. Enter the 'Date Collected' and 'Time Collected' as per when the specimen was taken. Include the collector’s name and select the specimen type, either urine or oral.
3. Complete the patient information section by providing the last name, first name, date of birth (DOB), social security number (SSN), and sex. Ensure you provide a contact number for both daytime and evening if available.
4. In the insurance information section, indicate whether the temperature was read within 4 minutes and confirm that it falls within the specified range. Also, include a copy of the front and back of the insurance card.
5. Outline the medications the patient is prescribed by checking all applicable boxes in the patient prescribed medications section. Remember that including a medication does not constitute a test request.
6. Select any additional drug confirmation requests by checking the appropriate drug class boxes for non point-of-care testing options.
7. Enter the diagnostic code(s) relevant to the patient's condition as indicated in the dedicated section. Provide internal codes or any that fit the purpose of the test.
8. Obtain the physician's authorization by ensuring they sign and date the requisition, affirming that the tests are medically necessary.
9. In the final sections, record point-of-care results and order confirmation tests by selecting the relevant boxes. Confirm any positive results as necessary.
10. Lastly, review all entered information for accuracy before saving the form. You may then download, print, or share the finalized requisition as needed.

Complete your Clarity Clinical Laboratory Toxicology Test Requisition online for an efficient testing process.