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Virology Requisition Provincial Laboratory for Public Health (Microbiology) 3030 Hospital Drive NW, Calgary, AB T2N 4W4 Phone 4039441200 FAX 4039441701 Ordering Physician: Code Patient Name (Last/
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How to fill out ahs virology requistion form

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How to fill out AHS Virology Requisition Form:

Complete the patient information section:

01
Provide the patient's full name, date of birth, and gender.
02
Include the patient's address and contact information.
03
Indicate the healthcare provider's name and contact information.

Specify the clinical details:

01
Fill in the clinical history, including relevant symptoms and the reason for requesting virology testing.
02
Describe any previous laboratory test results or relevant medical conditions.
03
If necessary, indicate any specific tests or viral targets requested.

Provide specimen details:

01
Specify the type of specimen being submitted (e.g., blood, urine, swab).
02
Indicate the source/site of the specimen (e.g., nasal swab, throat swab).
03
Include the date and time of specimen collection.

Select the appropriate tests:

01
Check the box(es) next to the specific tests requested.
02
If additional instructions or comments are necessary, write them in the designated space provided.

Complete the requisition details:

01
Enter the date and the referring healthcare provider's signature.
02
Include the provider's billing information, including any required billing codes or insurance details.

Who needs AHS Virology Requisition Form:

01
Healthcare providers, such as doctors, nurses, and other medical professionals, who suspect a viral infection or need to confirm a viral diagnosis for their patients.
02
Laboratories or diagnostic centers that require proper documentation and information to process virology tests accurately.
03
Research institutions or organizations conducting virology-related studies and experiments.
04
Public health departments or agencies involved in monitoring and investigating viral outbreaks or epidemics.
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The ahs virology requisition form is a document used to request virology testing for individuals.
Healthcare providers or individuals seeking virology testing are required to file the ahs virology requisition form.
To fill out the ahs virology requisition form, provide the required information such as patient details, reason for testing, and any relevant medical history.
The purpose of the ahs virology requisition form is to request virology testing for diagnostic or screening purposes.
The ahs virology requisition form typically requires information such as patient demographics, ordering physician details, specimen information, and testing requested.
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