Get Ny Laboratory Test Request 2014-2025

Filling out the NY Laboratory Test Request form online is essential for ensuring accurate processing of laboratory tests. This guide will help you navigate each section of the form step by step, making the process clear and straightforward.

Follow the steps to complete your laboratory test request form effectively.

1. Press the ‘Get Form’ button to access the NY Laboratory Test Request and open it in the editor.
2. Fill in the patient information section. Enter the patient’s first name, middle initial, last name, and date of birth in the specified fields. Ensure the spelling matches the specimen container.
3. Provide the gender of the patient by selecting either 'Male' or 'Female'. If applicable, enter the patient's medical record number and patient ID number.
4. Complete the address section with the patient’s city, state, zip code, and telephone number.
5. Proceed to the submitter information section. Here, you will input the name of the submitting hospital, laboratory, or facility, as well as the provider ID number.
6. Include the primary contact details, entering the first name and last name of the person submitting the form. Make sure to fill in their address, fax number, telephone number, state, city, and pager/cell number.
7. In the specimen information section, enter the date and time of collection. Select AM or PM as appropriate.
8. Next, provide the reason for submission by checking the relevant box, such as 'Outbreak' or 'DOHMH Request'. If applicable, complete the DOHMH investigation code and contact information sections.
9. Specify the specimen source and tests requested. Ensure you check all relevant boxes for the tests and sources used, such as 'Mumps IgG' or 'Mumps IgM' and the type of specimen like 'Blood Tube' or 'Swab'.
10. Once all sections are filled accurately, review the information for completeness. Save your changes and get ready to download, print, or share the completed form as needed.

Complete your NY Laboratory Test Request online to ensure timely processing of your laboratory tests.