Get the free Blood Lead Test Requisition Michigan ... - State of Michigan - michigan

Blood Lead Test Requisition Michigan Department of Community Health Bureau of Laboratories Trace Metals Section P.O. Box 30035 3350 North Martin Luther King Jr. Blvd. Lansing Michigan 48909 Phone:

How to fill out blood lead test requisition

How to fill out blood lead test requisition:

1. Start by providing your personal information. Fill in your full name, date of birth, address, and contact number in the designated fields.
2. Next, include the name of the healthcare provider or clinic that will be conducting the blood lead test. Write their name, address, and contact information.
3. Specify the reason for the blood lead test. This could be due to concerns of lead exposure at work, in the environment, or for medical evaluation.
4. Indicate your medical history if it is relevant to the blood lead test. Mention any past exposure to lead, occupation history, or any existing medical conditions that may be affected by lead exposure.
5. Provide insurance information, including your insurance company's name, policy number, and any required authorization or referral numbers.
6. Sign and date the requisition form to validate your request for a blood lead test.

Who needs blood lead test requisition:

1. Individuals who work in occupations where they may be exposed to lead, such as construction workers, stained glass artists, battery manufacturers, or plumbers, may need a blood lead test requisition.
2. Children who live in older homes with lead-based paint or who may have been exposed to other sources of lead contamination may require a blood lead test requisition.
3. Individuals who believe they may have been exposed to lead in their environment, such as living near a lead smelter or in an area with contaminated soil, should consider obtaining a blood lead test requisition.

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What is blood lead test requisition?

Blood lead test requisition is a form or document used to request a blood test to measure the level of lead in a person's blood.

Who is required to file blood lead test requisition?

Healthcare professionals, employers, or individuals responsible for ensuring the safety and health of workers or individuals exposed to lead are typically required to file blood lead test requisitions.

How to fill out blood lead test requisition?

To fill out a blood lead test requisition, provide the requested information such as the name and contact details of the individual being tested, the reason for the test, the date of the test, and any other required information as specified on the form.

What is the purpose of blood lead test requisition?

The purpose of a blood lead test requisition is to establish the level of lead in a person's blood in order to assess and monitor lead exposure, determine potential health risks, and guide appropriate medical interventions or workplace safety measures.

What information must be reported on blood lead test requisition?

The information required on a blood lead test requisition may vary, but typically includes the individual's name, contact information, date of birth, employer (if applicable), reason for the test, date of the test, and any other pertinent information as specified by the relevant authority or healthcare provider.