Get Record Of Loan Form

Filling out the Record Of Loan Form online is a straightforward process that ensures you provide all necessary information accurately. This guide will walk you through each section of the form to help simplify the completion process.

Follow the steps to successfully fill out the Record Of Loan Form online.

1. Click the ‘Get Form’ button to access the Record Of Loan Form and open it in your preferred online editor or form-filling application.
2. In the 'Request Information' section, enter the request date, phone number, full name of the person requesting the loan, the fax number, and the name of the institution making the request.
3. Indicate who should be billed for the materials by selecting either ‘Patient’ or ‘Requesting Clinician’. If there are any special requests for unstained slides, specify the number needed.
4. Provide the signature of the authorized requester to validate the form.
5. Next, complete the 'Patient Information' section by entering the patient’s full name (please print), date of birth, and the Inform Diagnostics accession number. Additionally, include the patient’s signature.
6. In the 'Shipping' section, remember that laboratory processing can take up to 72 hours before materials are shipped. Fill in the methods for shipping by selecting either overnight, two-day, or ground delivery and provide account numbers for the selected carriers.
7. Provide the shipping address by filling in Address Line 1, Address Line 2, city, state, phone, fax, and zip code where the materials should be sent.
8. In the 'For Inform Diagnostics Use Only' section, indicate whether recuts or originals are being sent and specify the number of slides or blocks that will be shipped.
9. Lastly, upon finishing the form, you can choose to save your changes, download a copy for your records, print it, or share it as needed.

Complete the Record Of Loan Form online today to facilitate your request!