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LABORATORY TEST REQUEST FOR SERVICE SAMPLE and CONSENT FORM Virology Department, USAMC-AFRIMS 315×6 Ravioli Road Bangkok 10400, Thailand TEL: 662-6445644 FAX: 662-6444760 All Laboratory data relevant
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How to fill out laboratory test request for

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How to Fill Out a Laboratory Test Request Form:

01
Begin by providing your personal information such as your name, contact details, and date of birth. This information helps identify the patient and ensures accurate test results.
02
Next, provide the reason for the laboratory tests. This can be a symptom or condition you're experiencing or a specific diagnostic purpose. The more specific you are, the better it is for the healthcare provider to determine the appropriate tests.
03
Include any relevant medical history or medications you are currently taking. This information assists the laboratory technicians in understanding your overall health condition and how it may impact the test results.
04
Indicate the desired tests you would like to be conducted. If you're unsure about which tests are necessary, consult with your healthcare provider who can guide you based on your symptoms or medical history.
05
If applicable, specify any specific instructions or requirements. Some tests may require fasting or specific preparations, and it is essential to follow these guidelines for accurate results. Your healthcare provider can provide you with the necessary instructions.
06
Mention the name and contact information of your healthcare provider who ordered the laboratory tests. This allows the lab to communicate the results directly to your provider for further analysis and discussion with you.
07
Finally, sign and date the form to verify that the information provided is accurate and complete.

Who Needs a Laboratory Test Request Form?

01
Patients Seeking Diagnosis: Individuals experiencing symptoms or conditions that require medical investigation often need a laboratory test request form to assess their health status accurately.
02
Routine Check-ups: Regular health check-ups may include various laboratory tests to evaluate overall wellness or identify any underlying health concerns. In such cases, a laboratory test request form is required.
03
Monitoring Chronic Conditions: Individuals with chronic diseases or conditions, such as diabetes or cardiovascular disease, may require periodic laboratory tests to monitor their health status and ensure treatment effectiveness.
04
Pre-Employment or Insurance Requirements: In certain cases, employers or insurance companies may request individuals to undergo specific laboratory tests to ensure they meet certain health criteria or to evaluate eligibility for coverage.
05
Research Purposes: Researchers may require laboratory tests for their studies to analyze specific biomarkers or evaluate the effectiveness of interventions. The laboratory test request form facilitates this process.
In conclusion, anyone seeking to understand their health status, diagnose a medical condition, or monitor a chronic illness may need to fill out a laboratory test request form. Consulting with a healthcare provider is essential to determine the necessary tests and provide accurate information on the form.
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