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FOR LAB USE ONLY PLEASE AFFIX SPECIMEN NUMBER BARCODE LABEL HERERequest for Laboratory Services MICROBIOLOGY DEPARTMENT St. James's Hospital, Dublin 8. Tel.: 4162941 / 4162966 / 4162967Request Details

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How to fill out external hospitals request form

01

Obtain the external hospitals request form from the specified department or person.

02

Fill out the patient's personal information such as name, date of birth, address, contact number, and insurance details.

03

Provide details about the requested procedure or treatment, including any specific instructions or preferences.

04

Include the name and contact information of the referring physician or healthcare provider.

05

Sign and date the form to confirm the accuracy of the information provided.

Who needs external hospitals request form?

01

Patients who require treatment or procedures that are not available at their current hospital.

02

Healthcare providers referring patients to external hospitals for specialized care.

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What is external hospitals request form?

The external hospitals request form is a document used to request services or information from hospitals outside of the organization.

Who is required to file external hospitals request form?

Any individual or department within the organization that needs to request services or information from external hospitals is required to file the form.

How to fill out external hospitals request form?

The form typically requires basic information such as contact details, the nature of the request, and any specific requirements. It is important to fill out the form accurately and completely.

What is the purpose of external hospitals request form?

The purpose of the external hospitals request form is to streamline the process of requesting services or information from hospitals outside of the organization and ensure that all necessary information is provided.

What information must be reported on external hospitals request form?

The form may require information such as the reason for the request, specific services needed, contact information, and any relevant deadlines.

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