Get Quest Requisition Form

Completing the Quest Requisition Form online is a straightforward process that ensures accurate and efficient submission of your requisition for laboratory tests. This guide provides a step-by-step approach to successfully fill out each section of the form while maintaining clarity and user-friendliness.

Follow the steps to complete the Quest Requisition Form online.

1. Press the ‘Get Form’ button to access the Quest Requisition Form and open it for editing.
2. In the 'Patient' section, provide the patient's full name, address, city, state, and zip code. It’s essential to ensure accuracy in these details for the records.
3. Fill in the requesting physician's information, including their name, NPI (National Provider Identifier), address, and phone numbers for home and work.
4. Indicate the patient's gender and race. Select appropriate billing information, identifying whether the charges should be billed to Medicare, Medicaid, insurance, the patient, the ordering physician, or the facility.
5. Enter the authorization number and policy/ID numbers for insurance coverage, including details for a secondary insurance if applicable.
6. Select the patient status whether they are a hospital inpatient, outpatient, or non-patient. Document the diagnosis in ICD-CM format, ensuring the specificity required at the date of service.
7. Fill in the collection date and time, and specify the type of specimen being collected.
8. Provide relevant history regarding any previous tests, urinary tract disorders, or current medications in the designated section.
9. Indicate the specific tests or profiles being requested. Make sure to check any boxes required for specific laboratory profiles or individual tests.
10. Finally, ensure the form is signed by the requesting physician. Review all inputs for correctness before proceeding to save the form, download a copy, or print for submission.

Complete your forms online today for a seamless laboratory testing experience.