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NAIL FUNGAL PANEL REQUISITION PATIENT INFORMATION Patient Name (Last, First)Date of Births ex c Male c Beale Street Addressing, State, Contact #Patient Ethnicity Caucasian Hawaiian/Pacific Islanders
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How to fill out nail fungal panel requisition
How to fill out nail fungal panel requisition
01
Start by providing your personal information, including your full name, date of birth, and contact details.
02
Indicate the name of the healthcare provider who will be interpreting the results.
03
Specify the reason for the nail fungal panel requisition, such as suspected nail infection or monitoring treatment.
04
Provide a detailed medical history, including any previous fungal infections or treatments.
05
Clearly mark the specific nails that need to be tested, if applicable.
06
Follow any instructions provided by the healthcare provider or laboratory, such as collecting nail clippings or scraping samples.
07
Ensure that the nail sample is collected in a clean and sterile manner to avoid contamination.
08
Pack the nail sample securely and label it with your name and date of collection.
09
Fill out the payment details and provide any necessary insurance information, if applicable.
10
Review the completed requisition form for accuracy and completeness before submitting it to the designated laboratory.
Who needs nail fungal panel requisition?
01
Anyone experiencing symptoms of a potential nail fungal infection, such as thickened, discolored, or brittle nails, may need a nail fungal panel requisition.
02
Individuals who have previously been diagnosed with a nail fungal infection and require monitoring of treatment effectiveness may also need this requisition.
03
Medical professionals, including dermatologists or podiatrists, who suspect or want to confirm a nail fungal infection in their patients may request a nail fungal panel requisition.
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