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Ship To: O'Donoghue Research Bldg 1122 NE 13 Street, Suite 1400 Oklahoma City, OK 73104 Phone: 4052713589 Fax: 4052717117 A hours phone: 4054969514 www.gene cs.outs.edu GENETICS LABORATORY MOLECULAR
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How to fill out genetics laboratory molecular requisition

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How to Fill out Genetics Laboratory Molecular Requisition:

01
Begin by filling out your personal information: Provide your full name, contact information, and any relevant identification numbers or codes provided by the laboratory.
02
Indicate the date of the requisition: Write down the current date when filling out the form.
03
Specify the referring physician or healthcare provider: Provide the name, contact information, and any relevant identification numbers of the healthcare professional who is requesting the genetic testing.
04
Include patient information: Provide the patient's full name, date of birth, gender, and any other relevant identifying details.
05
Mention the reason for the genetic testing: Clearly state the purpose of the requested test, whether it is for diagnosis, screening, or monitoring of a specific condition.
06
Provide a detailed medical history: Include information about the patient's symptoms, previous diagnoses, current medications, and any relevant family history of genetic conditions.
07
Select the type of test(s) requested: Specify the specific genetic test(s) being requested by checking the appropriate boxes or providing specific codes if provided by the laboratory.
08
Payer information: Indicate the relevant insurance information, including policy or group numbers, for billing purposes. If the patient is self-paying, mark the appropriate option.
09
Include any additional requested information: Some laboratories may require additional information or documents for processing the requisition. Make sure to provide any required supporting documents or indicate if they will be sent separately.
10
Sign and date the requisition form: Affirm that all the provided information is accurate by signing and dating the form.

Who Needs Genetics Laboratory Molecular Requisition:

01
Patients seeking a genetic diagnosis: Individuals with suspected genetic conditions may require genetic testing to confirm the diagnosis and provide appropriate treatment or management options.
02
Healthcare professionals: Physicians, specialists, or other healthcare providers who suspect a genetic component in a patient's condition may request genetic testing to aid in diagnosis, treatment decisions, or genetic counseling.
03
Researchers and scientists: Genetics laboratory molecular requisitions may also be required by researchers or scientists conducting genetic studies or experiments to analyze specific genes or mutations.
Note: The specific individuals who need a genetics laboratory molecular requisition may vary depending on the specific laboratory's policies and the purpose of the genetic testing. It is always recommended to consult with healthcare professionals or the laboratory itself for accurate information.

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