Get Telehealth Request Form - Douglass Hanly Moir Pathology

This guide provides a detailed overview of how to successfully complete the Telehealth Request Form for Douglass Hanly Moir Pathology online. Whether you are familiar with digital forms or new to the process, this guide will walk you through each step with clear instructions and helpful tips.

Follow the steps to complete the Telehealth Request Form online.

1. Press the ‘Get Form’ button to access the Telehealth Request Form and open it for editing.
2. Begin filling in the patient information section, which includes fields for the patient's surname, given names, date of birth, Medicare card number, address, and contact numbers. Ensure all details are accurate to prevent delays.
3. Indicate the patient's sex by selecting the appropriate option provided in the form. This information is necessary for proper identification.
4. In the 'Tests Requested' section, select the tests that have been recommended. Options may include fasting, non-fasting, or specific pregnancy-related tests, among others.
5. Complete the 'Clinical Notes' section if applicable. This space allows for additional relevant information that the practitioner may need.
6. Fill in the referring practitioner’s information, including their provider number, name, and address, to ensure proper processing of the request.
7. Ensure that the practitioner’s signature and request date are included. Note that there is no signature required for telehealth services.
8. If necessary, provide details regarding the patient’s hospital status at the time of specimen collection or service date.
9. Once all sections are completed, review the information for accuracy. You may then save the form, download it, print a copy, or share it as needed.

Complete your Telehealth Request Form online now for efficient service.