Get the free Molecular Diagnostic Requisition - Baylor Miraca Genetics

PHONE: 800411GENE FAX: 7137982787 www.bmgl.com SHIP TO: Baylor Maraca Genetics Laboratories 2450 Holcombe, Grand Blvd. Receiving Dock Houston, TX 770212024 Phone: 7137986555 MOLECULAR DIAGNOSTIC REQUISITION

How to fill out molecular diagnostic requisition

How to fill out a molecular diagnostic requisition:

1. Start by gathering all the necessary information. This includes the patient's full name, date of birth, gender, and contact information. Additionally, you will need the ordering physician's name and contact information.
2. Next, indicate the reason for the diagnostic test. Provide a brief description of the symptoms or condition that necessitates the molecular diagnostic test.
3. Specify the type of specimen being submitted for analysis. Common specimens include blood, saliva, tissue samples, or urine. Be sure to label the specimen container clearly and accurately.
4. Indicate the specific test(s) requested. Molecular diagnostic tests encompass a wide range of analyses, such as genetic testing, infectious disease screening, or cancer marker detection. Clearly state the name of the test and any relevant codes associated with it.
5. Include any relevant medical history or clinical information that may assist the laboratory in interpreting the results. This could include previous test results, relevant medications, or recent procedures.
6. Specify the desired turnaround time for the test results. If there is urgency, it is important to highlight this to ensure appropriate prioritization.
7. Provide accurate billing information. This may include insurance details, billing address, and any necessary authorizations or pre-approvals.
8. Finally, sign and date the requisition form. Ensure that all necessary signatures are obtained, including the ordering physician's signature.

Who needs a molecular diagnostic requisition:

1. Physicians and healthcare providers who suspect a genetic disorder or disease and require further investigation.
2. Researchers conducting studies related to genetics, genomics, or molecular biology that necessitate molecular diagnostic testing.
3. Patients who have been referred for genetic counseling or screening for specific genetic conditions.

In summary, anyone involved in the identification, diagnosis, or research of genetic disorders or diseases may need to fill out a molecular diagnostic requisition. It serves as a formal request for a specific test or analysis to be conducted on a patient's specimen.

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What is molecular diagnostic requisition?

Molecular diagnostic requisition is a document that requests molecular testing to diagnose or monitor a medical condition.

Who is required to file molecular diagnostic requisition?

Healthcare providers or physicians are required to file molecular diagnostic requisition for their patients.

How to fill out molecular diagnostic requisition?

To fill out molecular diagnostic requisition, the healthcare provider needs to provide patient information, requested tests, and relevant clinical information.

What is the purpose of molecular diagnostic requisition?

The purpose of molecular diagnostic requisition is to facilitate accurate and timely molecular testing for medical diagnosis or treatment decisions.

What information must be reported on molecular diagnostic requisition?

Patient demographics, tests requested, clinical history, date of specimen collection, and healthcare provider information must be reported on molecular diagnostic requisition.