Lab requisition 2026

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The document is a laboratory requisition form for biochemical genetics and cystine testing at the University of California, San Diego. It includes sections for patient information, physician details, sample collection specifics, test selection, and clinical history required for interpretation. The form outlines various tests related to metabolic disorders, particularly focusing on cystinosis and associated assays.

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Click ‘Get Form’ to open the lab requisition in the editor.
Begin by entering the patient’s name in the designated field at the top of the form. Ensure accuracy for proper identification.
Fill in the date of birth and sex fields. This information is crucial for patient records and billing purposes.
Complete the physician information section, including requesting physician's name, state license number, and billing address. This ensures that results are sent to the correct location.
In the sample information section, indicate the collection date and time. Select only one specimen type per requisition as specified.
Mark your test or service selection clearly, circling the appropriate specimen type as indicated in the specimen key.
Provide any necessary clinical history in section four to assist with interpretation of results.

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