Get the free LABORATORY TEST REQUISITION FORM - University of... - pathology washington

Peter H. Byers, MD, University of Washington, Room D-518 Health Sciences, 1959 NE Pacific St, Seattle, WA 98195-7470 Main Phone (206) 543-0459; Genetic Counselors (206) 543-5464; Fax (206) 616-1899;

How to fill out laboratory test requisition form

How to fill out a laboratory test requisition form:

1. Gather the necessary information: Before filling out the form, gather all relevant information such as the patient's full name, date of birth, address, and contact information.
2. Provide healthcare provider information: Include the name, address, and contact details of the healthcare provider who ordered the laboratory test.
3. Specify the type of test: Indicate the specific type of test or tests needed by checking the appropriate box or providing the necessary details. This could be a blood test, urine test, imaging test, or any other type of laboratory test.
4. Include relevant clinical information: It is important to provide the healthcare provider with any relevant clinical information that may assist in the interpretation of the test results. This can include medical history, current medication usage, and any known allergies.
5. Complete patient demographic details: Fill in all necessary patient demographic details, such as their age, gender, and any relevant medical insurance information.
6. Consent and signature: The patient or their legal guardian should read and sign the consent section of the requisition form to authorize the laboratory test.
7. Submit the form: Once the form is completed, ensure that all required fields are filled out accurately. Submit the form to the appropriate laboratory or healthcare facility either in person or through the recommended channels.

Who needs a laboratory test requisition form:

1. Patients: Patients who require laboratory testing as part of their diagnostic process or ongoing healthcare management may need to fill out a laboratory test requisition form. This form provides the necessary information for healthcare providers to accurately order and interpret the test results.
2. Healthcare providers: Healthcare providers, including doctors, nurse practitioners, and other medical professionals, may need to fill out a laboratory test requisition form when ordering specific tests for their patients. This ensures that the correct test is conducted and that the results are properly recorded and interpreted.
3. Laboratory technicians: Laboratory technicians and staff involved in the processing and analysis of laboratory tests rely on the information provided on the requisition form to carry out the necessary tests. This form acts as a communication tool between healthcare providers and the laboratory, ensuring that the correct tests are performed accurately and efficiently.

For pdfFiller’s FAQs

What is laboratory test requisition form?

Laboratory test requisition form is a document used to request specific tests to be performed on a patient's sample.

Who is required to file laboratory test requisition form?

Healthcare providers, doctors, or other medical professionals are required to file laboratory test requisition forms.

How to fill out laboratory test requisition form?

Fill out the patient information, requested tests, date and time of collection, and any other relevant details on the form.

What is the purpose of laboratory test requisition form?

The purpose of the laboratory test requisition form is to ensure that the correct tests are performed on the patient's sample.

What information must be reported on laboratory test requisition form?

Patient's name, date of birth, tests requested, date and time of sample collection, and any relevant clinical information must be reported on the form.

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