Get Gi Lab Order - Vanderbilt University Medical Center - Mc Vanderbilt

Filling out the GI Lab Order form ensures accurate processing of procedures and patient information. This guide provides step-by-step instructions for completing the form online, helping users navigate through each section with ease.

Follow the steps to successfully complete the GI Lab Order form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Complete the VUMC MR# section if applicable, providing the medical record number for identification.
3. Fill in the Date Referred section to indicate when the referral is made.
4. Specify the procedure requested by clearly entering the details in the provided field.
5. Identify the diagnosis relevant to the procedure, ensuring accurate details are documented.
6. List the GI physician requested for the procedure; select one of the circlable options: First Available, ASAP, or Urgent.
7. In the Patient Information section, input the patient's name, date of birth, and phone numbers, including home, work, and cell.
8. Provide the patient’s email address to facilitate communication.
9. Enter the referring physician's name along with their phone and fax numbers.
10. Record the primary care physician’s contact details, including phone and fax.
11. Indicate the primary insurance provider and fill in the subscriber’s name and ID number.
12. Answer the questions regarding anti-coagulation therapy and PPI therapy accurately.
13. If applicable, include the name and contact information of the person managing anti-coagulation therapy.
14. Ensure to include a contact person with their phone and fax numbers.
15. The form requires an MD signature; ensure it is signed before submission.
16. Fill in the scheduled date and time for the procedure.
17. Indicate the handouts given, such as Medipac or Endoworks, if applicable.
18. Once all fields are completed, you can save changes, download, print, or share the form as needed.

Complete your documents online today for efficient processing.