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This document is intended for submitting test requisitions to the San Diego County Public Health Laboratory, requiring specific patient information, specimen sources, and the tests requested.

How to fill out test requisition form

How to fill out test requisition form

1. Obtain the test requisition form from your healthcare provider or laboratory.
2. Fill in the patient's full name and date of birth in the designated fields.
3. Provide any relevant contact information for the patient.
4. Indicate the specific tests required by checking the appropriate boxes or writing them in, if necessary.
5. Include the ordering physician's name, contact information, and signature.
6. Note the date and time the test is ordered.
7. If needed, add any additional clinical information or patient history that may assist the laboratory.
8. Review the completed form for accuracy before submission.

Who needs test requisition form?

1. Healthcare providers who need to order diagnostic tests for their patients.
2. Laboratories that require a formal request to process medical tests.
3. Patients who want to ensure their tests are properly ordered and documented.

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What is test requisition form?

A test requisition form is a document used to request laboratory tests or procedures. It includes essential information necessary for processing the request and ensuring accurate testing.

Who is required to file test requisition form?

Healthcare providers such as physicians, nurse practitioners, or physician assistants are typically required to file a test requisition form when ordering laboratory tests for patients.

How to fill out test requisition form?

To fill out a test requisition form, a healthcare provider should include patient information (such as name, DOB, and ID number), test(s) requested, clinical information or symptoms, and the provider's details and signature.

What is the purpose of test requisition form?

The purpose of a test requisition form is to communicate the need for specific laboratory tests, provide necessary patient and clinical information, and facilitate the ordering and tracking of tests.

What information must be reported on test requisition form?

Information that must be reported on a test requisition form includes patient demographics (name, age, gender), test(s) being requested, relevant clinical history or symptoms, provider information, and any special instructions.