Get Pulmonary Function Lab Test Requisition - Akronchildrens

Filling out the Pulmonary Function Lab Test Requisition is an important step in ensuring that patients receive the appropriate pulmonary function tests. This guide provides a comprehensive, step-by-step approach to help you complete the form accurately and efficiently.

Follow the steps to complete the requisition form accurately

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient's name in the designated field. This is crucial for proper identification.
3. In the referring doctor section, provide the name of the physician who is initiating the requisition.
4. Fill in the date of birth of the patient, ensuring accuracy to match their medical records.
5. Enter the phone number of the referring doctor for any necessary follow-ups.
6. Specify the insurance details in the corresponding field to assist with billing and coverage.
7. Input the fax number of the referring doctor for communication purposes.
8. Provide a clear diagnosis in the appropriate section, as this will guide the testing process.
9. Enter the diagnosis code number if applicable, which aids in the categorization of the condition.
10. Input the patient's phone number for any necessary follow-ups or clarifications.
11. Complete the medical record (MR) number field if the patient is a current patient at the facility.
12. Fill out the patient's address in the designated space to ensure correct correspondence.
13. Select the tests required by marking the corresponding checkboxes. Ensure to include any additional required tests based on the patient's condition.
14. Provide the physician’s signature along with the date to validate the requisition. This signifies approval for the requested tests.
15. After checking all entries for accuracy, save changes to the form. You can then download, print, or share the completed document as needed.

Complete your Pulmonary Function Lab Test Requisition online to ensure timely and accurate testing.