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MEMORANDUM Date: From: Subject: Purpose: Revisions: Instructions for use: Questions:1/5/2018 Wade. Aldous, PhD, DiseaseControlDirector, StateHygienicLaboratory RevisionstoSHLClinicalTestRequestForms
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How to fill out clinical test request form
How to fill out clinical test request form
01
To fill out a clinical test request form, follow these steps:
02
Start by writing the name of the patient in the designated field.
03
Provide the date of birth, gender, and contact information of the patient.
04
Specify the name of the referring physician or healthcare provider.
05
Write down the reason for the clinical test request.
06
Indicate the type of test or tests required.
07
If necessary, provide additional details or instructions for the laboratory.
08
Make sure to include any relevant medical history or previous test results, if applicable.
09
Sign and date the form to confirm your authorization for the tests.
10
Double-check all the filled information for accuracy before submitting the form.
11
Submit the completed form to the designated laboratory or healthcare facility.
Who needs clinical test request form?
01
Clinical test request forms are needed by healthcare professionals or physicians who require specific tests to be conducted on their patients.
02
These forms are typically used by doctors, specialists, and other medical practitioners to ensure accurate and timely clinical testing of their patients.
03
Patients themselves do not usually need the form unless their healthcare provider requests them to fill out specific sections.
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