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For laboratory use only Date received (YYY/mm/dd):COVID-19 and Respiratory Virus Test Requisitions ALL Sections of this form must be completed at every visit2 Patient Information1 Submitter Lab Number

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How to fill out commonly ordered covid-19 influenza

01

Wash your hands or use hand sanitizer before handling the form.

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Fill out all personal information accurately, including name, date of birth, contact information, and other required details.

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Specify whether you have any symptoms related to Covid-19 or influenza.

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Who needs commonly ordered covid-19 influenza?

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Individuals who are experiencing symptoms related to Covid-19 or influenza.

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Those who have been in close contact with someone diagnosed with Covid-19 or influenza.

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People who need to undergo testing for travel, work, or school requirements.

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What is commonly ordered covid-19 influenza?

Commonly ordered covid-19 influenza tests include PCR tests and rapid antigen tests.

Who is required to file commonly ordered covid-19 influenza?

Healthcare providers and testing facilities are required to file commonly ordered covid-19 influenza.

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Commonly ordered covid-19 influenza tests can be filled out by providing patient information, test type, results, and date of testing.

What is the purpose of commonly ordered covid-19 influenza?

The purpose of commonly ordered covid-19 influenza tests is to diagnose and monitor the presence of the COVID-19 virus in individuals.

What information must be reported on commonly ordered covid-19 influenza?

Commonly ordered covid-19 influenza tests require reporting of patient demographics, test results, and testing date.

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