Get Frat Laboratory Test Form - Iliad Neurosciences Inc.

Completing the FRAT Laboratory Test Form online is a straightforward process that ensures accurate collection of necessary information for your laboratory tests. This guide provides you with clear, step-by-step instructions to help you fill out the form efficiently and correctly.

Follow the steps to fill out the FRAT Laboratory Test Form accurately.

1. Use the ‘Get Form’ button to access the FRAT Laboratory Test Form. This action allows you to open the document in an editable format.
2. Begin with the facility information section. Clearly print the physician's name, facility name, contact details, and the specimen type in blue or black ink.
3. Next, fill in the patient's information. Include the patient’s first and last name, date of birth, and gender. If the patient is represented by a responsible party, include their information as well.
4. Complete the diagnosis fields by providing the applicable diagnosis and diagnosis code(s). Also, include the date and time the specimen was collected.
5. Indicate your preferred method for receiving results. Options may include email, fax, or other methods.
6. Provide the payment information section by noting the cost of FRAT testing and selecting your payment method. Fill in the credit card details or, if mailing a check, ensure it is made payable to Iliad Neurosciences, Inc.
7. Review the patient consent and authorization section. Ensure the patient's acknowledgment of understanding regarding the tests and authorization for the necessary records is properly documented.
8. Finally, after reviewing all the entered information for accuracy, save the form. You may choose to download, print, or share the completed form as necessary.

Start filling out your FRAT Laboratory Test Form online today for a seamless testing experience.