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PATIENT REGISTRATION FORM
Michigan Medicine
Laboratories (Labs)
FLNC Specimen Processing
2800 Plymouth Rd, Bldg 35
Ann Arbor, MI 481092800
734.936.2598 800.862.7284 labs.Mich.edu
FAX: 734.936.0755Patient
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How to fill out add-on test request form
How to fill out add-on test request form
01
Obtain the add-on test request form from the testing facility or download it from their website.
02
Fill in your personal information such as name, contact details, and any identification number required.
03
Specify the type of test you are requesting as an add-on to your existing test.
04
Provide any relevant medical history or information that may be necessary for the test.
05
Sign and date the form to confirm your request and consent to the additional test.
Who needs add-on test request form?
01
Individuals who have already scheduled a test and wish to add on additional testing
02
Patients who require further diagnostic information or testing beyond their initial appointment
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What is add-on test request form?
The add-on test request form is a form used to request additional tests or assessments beyond what was originally planned or requested.
Who is required to file add-on test request form?
Anyone who wants to add additional tests or assessments to their original request is required to file the add-on test request form.
How to fill out add-on test request form?
To fill out the add-on test request form, simply provide the necessary information regarding the additional tests or assessments being requested.
What is the purpose of add-on test request form?
The purpose of the add-on test request form is to ensure that any additional tests or assessments are properly documented and processed.
What information must be reported on add-on test request form?
The add-on test request form must include details about the additional tests or assessments being requested, as well as the reason for the request.
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