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IMPORTANT Mailing container contains one request form a plastic spoon and two media bottles one contains 10 Formalin and the other PVA Polyvinyl Alcohol fixative. The submitter should allow sufficient transit time for the USPS to deliver results. Results will be sent as photocopies of the original report. PARASITOLOGY Reset Form State Form 13053 R5/10-07 CLIA Certified Laboratory 15D0662599 Patient s Name Last INDIANA STATE DEPARTMENT OF HEALTH LABORATORIES th 550 W. 16 Street Suite B...
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How to fill out patient's name last:

01
Start by locating the field or section on the form where the patient's name is to be filled out.
02
Begin by writing the patient's last name in the designated space. Make sure to write the name accurately and without any spelling errors.
03
If there is a separate field for the patient's first name, middle name, or initials, fill those out accordingly in the appropriate spaces.
04
Double-check the spelling and accuracy of the patient's name before submitting the form.

Who needs patient's name last:

01
Medical professionals: Doctors, nurses, and other healthcare providers require the patient's name last to accurately identify and document medical records, test results, and treatment plans.
02
Hospitals and clinics: Healthcare facilities use the patient's name last to maintain organized records, ensure proper billing, and prevent confusion among patients with similar names.
03
Insurance companies: Insurers may require the patient's name last for claims processing, policy administration, and accurately matching medical records with insurance policies.
04
Pharmacists and pharmacies: When dispensing medications or managing prescription records, pharmacists need the patient's name last for accurate documentation and patient identification.
Overall, anyone involved in the healthcare or medical billing process may require the patient's name last for various administrative and organizational purposes. By providing this information correctly, it helps ensure effective communication, efficient record-keeping, and appropriate patient care.
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The patient's name last refers to the surname or last name of the patient.
Healthcare providers or facilities are required to document and report the patient's name last in medical records and billing forms.
In order to fill out the patient's name last, simply enter the last name or surname of the patient in the designated field.
The purpose of including the patient's name last is to accurately identify the individual and maintain proper record-keeping in healthcare settings.
Only the patient's last name or surname needs to be reported on the patient's name last.
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