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- Click ‘Get Form’ to open the Microbiology/Molecular Infectious Disease Requisition in the editor.
- Begin with Part A – Patient Information. Fill in the required fields including Patient Last Name, First Name, Address, Phone, Date of Birth, and Gender. Ensure all information is accurate for proper identification.
- Proceed to Part B – Provider Information. Enter details about the referring institution and physician, including their contact information. This section is crucial for communication regarding test results.
- In Part C – Specimen Information, specify the collection date and time. Select the type of specimen collected and provide any necessary ICD-10 codes. Be thorough to avoid processing delays.
- Complete Part D – Billing Information by providing details for primary and secondary insurance coverage if applicable. Attach copies of insurance cards as required.
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