Get Labtech Diagnostics Test Requisition Form 2020-2025

Filling out the Labtech Diagnostics Test Requisition Form accurately is essential for effective testing and minimal delays. This guide will provide you with clear steps to complete the form online, ensuring that you provide all necessary information for optimal processing.

Follow the steps to complete the Labtech Diagnostics Test Requisition Form online:

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient information. Provide the last name, first name, date of birth, and the facility name and address. Ensure you also include the patient’s phone number and their address, including city, state, and zip code.
3. Fill out the requesting physician section with the physician's name and specify who the billing is directed to (patient, client, insurance, or Medicare). Input the physician's NPI number in the appropriate field.
4. Include the insurance information if applicable. Make sure to attach a copy of the front and back of the insurance card or its face sheet.
5. Specify a critical value contact phone number and an alternate fax number for reporting, if different.
6. Add any relevant comments and ensure you include the physician's signature, which is required, along with the date and time.
7. In the sample information section, clearly indicate the test or tests ordered. Be specific to include all requested tests and their corresponding codes.
8. Input the sample collection date and time as per the guidelines provided. Make sure to follow the sample collection guidelines for each test.
9. Review all entries for accuracy and completeness before finalizing the form.
10. Once completed, save your changes, then download or print the form. Ensure to fax or email a copy along with any needed documents to Patients Choice Lab.

Complete your Labtech Diagnostics Test Requisition Form online today for efficient processing.