Get Bmgdl Genetic Test Requisition Form - University Of Miami

Filling out the Bmgdl Genetic Test Requisition Form is a crucial step in initiating genetic testing. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the form online.

1. Press the ‘Get Form’ button to access the requisition form and open it for editing.
2. Begin by filling out the patient information section. Enter the last name, first name, date of birth, sex, and ethnicity of the patient. Make sure to include the collection date and time for the specimen.
3. In the specimen information section, specify the type of sample being submitted (e.g., blood, saliva, or buccal). Indicate if the patient has had a blood transfusion within the last four weeks.
4. Provide the ordering physician's information. This includes their name, credentials, signature, NPI number, and contact details such as phone and fax numbers.
5. Complete the patient insurance information, including the insurance company, member ID, authorization number if available, and the relationship to the primary insured individual.
6. Ensure all required indications for testing are filled out, including the ICD-10 code, the status of the individual tested, presenting features, and any relevant family history.
7. Review the patient informed consent section and ensure that it is signed by the patient or their legal guardian, acknowledging understanding of the implications of genetic testing.
8. Finally, check all entries for accuracy. Once completed, you can save changes to the form, download it for your records, print a copy, or share it as needed.

Take the first step towards genetic testing by completing the Bmgdl Genetic Test Requisition Form online today.