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Date of Request Chart # *4010* Visit Number: Location: Ordering Provider: Patient Name Attending Provider: BASSETT HEALTHCARE NETWORK RHEUMATOLOGY LAB REQUEST FORM #13 ×4010 12/17/07,7/1/08,8/11/08,10/06/08,1/5/09,4/6/09,7/6/09,10/5/09,1/4/10

How to fill out hematology laboratory requisition

How to fill out hematology laboratory requisition

1. Read the instructions provided on the hematology laboratory requisition form.
2. Fill in your personal information, such as your name, date of birth, gender, and contact details.
3. Provide the necessary clinical information, including your medical history, previous lab results, and any specific instructions from your healthcare provider.
4. Specify the type of test(s) you require from the hematology laboratory, such as a complete blood count (CBC) or a blood smear.
5. Indicate the urgency of the test(s) if applicable.
6. If you have any known allergies or are taking any medications, mention them on the requisition form.
7. Make sure to sign and date the requisition form before submitting it to the hematology laboratory.
8. If required, attach any supporting documents or referral forms provided by your healthcare provider.
9. Submit the completed hematology laboratory requisition form to the designated laboratory or healthcare facility as instructed.

Who needs hematology laboratory requisition?

1. Individuals who have been referred by their healthcare provider for specific blood tests or a comprehensive blood evaluation.
2. Patients who suspect they have a blood disorder and require a detailed analysis of their blood components.
3. Individuals undergoing medical treatments or therapies that necessitate regular blood monitoring.
4. Individuals participating in clinical trials or research studies that involve blood analysis.
5. Preoperative patients who need to undergo blood tests as part of their pre-surgical evaluation.
6. People with chronic illnesses, such as diabetes or kidney disease, who require ongoing blood tests for disease management.
7. Individuals with a family history of blood disorders or genetic conditions that affect blood production or function.
8. Athletes or individuals involved in sports activities where blood analysis is required for performance assessment or doping control.
9. Healthcare professionals who need to order and interpret blood tests for their patients' diagnosis and treatment.

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What is hematology laboratory requisition?

Hematology laboratory requisition is a form used to request specific lab tests related to blood disorders and diseases.

Who is required to file hematology laboratory requisition?

Healthcare providers, doctors, or nurses are required to file hematology laboratory requisition for their patients.

How to fill out hematology laboratory requisition?

To fill out a hematology laboratory requisition, one must specify the patient's information, the tests to be performed, and any relevant medical history.

What is the purpose of hematology laboratory requisition?

The purpose of hematology laboratory requisition is to provide healthcare providers with necessary information to diagnose and treat blood-related conditions.

What information must be reported on hematology laboratory requisition?

Patient's name, date of birth, medical history, requested tests, and relevant clinical information must be reported on hematology laboratory requisition.