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LAB1201AFRM REV 5 8.7.18Agency Outpatient Lab Orders pH (843) 3478130 Fax (843) 2345479 FIN # ___DATE___Conway Medical Center 300 Singleton Ridge Road, Conway, South Carolina 29526 REQUIRED PHYSICIAN
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How to fill out agency outpatient lab orders

01
Obtain the agency outpatient lab order form from the appropriate source.
02
Fill out the patient's personal information such as name, date of birth, and identification number.
03
Specify the tests that need to be conducted by checking the appropriate boxes or writing them down.
04
Provide any additional instructions or comments for the lab technician, if necessary.
05
Obtain necessary signatures from the ordering physician and the patient.
06
Submit the completed agency outpatient lab order form to the lab for processing.

Who needs agency outpatient lab orders?

01
Patients who have been referred by their healthcare provider for specific lab tests outside of the hospital setting.
02
Healthcare providers who want to order lab tests for their patients without requiring them to be admitted to the hospital.
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Agency outpatient lab orders are requests for laboratory tests or services that are prescribed by a healthcare provider for patients who are not admitted to a hospital.
Healthcare providers or laboratories are required to file agency outpatient lab orders.
Agency outpatient lab orders can be filled out by the healthcare provider or laboratory staff by entering the required patient information, test requests, and any supporting documentation.
The purpose of agency outpatient lab orders is to ensure that patients receive the necessary laboratory tests or services in an outpatient setting.
Agency outpatient lab orders must include patient demographics, test orders, physician information, and any relevant clinical information.
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