Get the free Test Requisition Form - Oregon Health & Science University - ohsu

TEST REQUISITION. Ocular Immunology Laboratory. Oregon Health & Science University. Casey Eye Institute BRB, Room 253. 3181 SW Sam Jackson Park ...

How to fill out test requisition form

How to fill out a test requisition form:

1. Start by writing your personal information at the top of the form. This may include your full name, date of birth, address, and contact information.
2. Next, indicate the name of the test or tests that you are requesting. Be sure to provide as much detail as possible, including the specific type of test and any additional instructions or preferences.
3. If you have a healthcare provider, make sure to include their name, address, and contact information in the designated section. This is important for proper communication and reporting of test results.
4. Write down any relevant medical history or symptoms that may be helpful for the healthcare provider to know. This can assist in determining the appropriate tests to order and interpreting the results accurately.
5. If applicable, provide information about your insurance coverage. This may include your insurance provider's name, policy number, and any necessary authorizations or referrals.
6. Make sure to read and understand any terms and conditions stated on the form before signing it. By signing, you acknowledge that you have provided accurate information and agree to the terms set forth by the testing facility.
7. Keep a copy of the completed form for your records and submit the original to the designated testing facility or healthcare provider's office.

Who needs a test requisition form?

1. Individuals seeking specific diagnostic tests or screenings typically require a test requisition form. These tests may be ordered by healthcare providers, such as doctors, nurses, or other medical professionals.
2. Patients who wish to undergo certain medical examinations or screenings may also need a test requisition form. This could include individuals who suspect they have a particular condition, those seeking routine check-ups, or individuals participating in health research studies.
3. Testing facilities, laboratories, or clinics generally require a test requisition form to ensure accurate processing of the requested tests and appropriate billing procedures. The form helps maintain a standardized and organized process for test requests.

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