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CORE LABORATORY: CHEMISTRY REQUISITION PATIENT NAME:SEX:MRobert W. Doms, M.D., Ph.D., PathologistinChief FDate: ___ Diagnosis / ICD10: ___MRN:Ordering Physician / CRNP: ___AGE / DATE OF BIRTH: ACCT
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How to fill out core laboratory chemistry requisition

01
Obtain the core laboratory chemistry requisition form from your institution.
02
Fill in the patient's demographic information including name, date of birth, and medical record number.
03
Indicate the ordering physician's name and contact information.
04
Specify the tests required by checking the corresponding boxes on the form.
05
Include any necessary clinical information or reason for testing in the designated section.
06
Provide sample collection details such as the date and time of sample collection.
07
Ensure all required signatures are present, including the physician's.
08
Review the completed form for accuracy before submission to the laboratory.

Who needs core laboratory chemistry requisition?

01
Healthcare providers and physicians who require laboratory tests for patient diagnosis and monitoring.
02
Patients who are undergoing testing in a clinical setting or as part of routine healthcare checks.
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A core laboratory chemistry requisition is a standardized form used to request various laboratory tests and analyses related to chemical substances in samples, typically blood or other bodily fluids.
Healthcare providers, such as doctors and nurses, who are ordering laboratory tests for their patients are required to file the core laboratory chemistry requisition.
To fill out a core laboratory chemistry requisition, one must provide patient information, specify the tests to be conducted, include any relevant clinical history, and ensure that all required fields are completed accurately.
The purpose of the core laboratory chemistry requisition is to facilitate the accurate and efficient processing of laboratory tests, ensuring that the necessary information is conveyed to the laboratory for proper analysis.
The requisition must include patient identifiers (like name and ID), the requested tests, the physician's details, sample type, collection date and time, and any pertinent clinical information.
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