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Laboratory Services Outpatient Order Form - Northwestern 2026

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The document provides information about Laboratory Services at Northwestern Medicine Lake Forest Hospital, including details on how to schedule appointments, a list of available tests, and instructions for completing the order form. It emphasizes the need for patient and physician information, as well as specific requirements for certain tests.

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Click ‘Get Form’ to open it in the editor.
Begin by selecting the appropriate tests from the 'TEST NAME' section. Check all that apply to ensure accurate processing.
Fill in the 'PATIENT INFORMATION' section with the patient's last name, first name, date of birth, gender, and contact numbers. Ensure all fields are completed for efficient service.
In the 'PHYSICIAN INFORMATION' section, provide your last name, first name, NPI number, fax number, and signature. This information is crucial for verification.
Indicate any signs, symptoms, diagnosis or ICD codes in the designated area. This helps in processing multiple tests accurately.
Review all entries for accuracy before submitting. Once complete, fax the order to 847.535.8001 as instructed.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (118 Votes)
2008	4.2 Satisfied (25 Votes)

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Is Northwestern Memorial Healthcare the same as Northwestern Medicine?

Northwestern Medicine, formerly Northwestern Memorial Healthcare, is a non-profit healthcare system affiliated with the Northwestern University Feinberg School of Medicine, in Chicago, Illinois. Members include research hospitals, acute care facilities, and academic centers.

How do I schedule a lab appointment at Northwestern?

Patients of the NMC Lab preregister and reserve a time slot for lab work. Heres how this process works: To pre-register, call 802-524-1070 on weekdays between the hours of 8 am to 4:30 pm, and choose option #1 to speak with a scheduling representative.

How do I report an issue at Northwestern Medicine?

Patient Relations Contact Information Dial 711 or 800.526. 0857, followed by the individuals 10-digit TDD/TTY phone number. You can find phone numbers for Patient Relations on our Patient Relations contact page. You may also submit a complaint or compliment via our Contact Us form.

How much do Northwestern doctors make?

How much does Northwestern Medicine - Physicians Surgeons in the United States pay? The average Northwestern Medicine salary ranges from approximately $75,318 per year for Physician to $266,758 per year for Anesthesiologist.

Laboratory Services Outpatient Order Form - Northwestern 2026

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How to use or fill out Laboratory Services Outpatient Order Form - Northwestern

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What is the optimum way to electronically sign my Laboratory Services Outpatient Order Form - Northwestern?

Do I need to set up software to modify my Laboratory Services Outpatient Order Form - Northwestern?

Is Northwestern Memorial Healthcare the same as Northwestern Medicine?

How do I schedule a lab appointment at Northwestern?

How do I report an issue at Northwestern Medicine?

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Laboratory Services Outpatient Order Form - Northwestern 2026

Here's how it works

How to use or fill out Laboratory Services Outpatient Order Form - Northwestern

See more Laboratory Services Outpatient Order Form - Northwestern versions

Complete this form in 5 minutes or less

Got questions?

What is the optimum way to electronically sign my Laboratory Services Outpatient Order Form - Northwestern?

Do I need to set up software to modify my Laboratory Services Outpatient Order Form - Northwestern?

Is Northwestern Memorial Healthcare the same as Northwestern Medicine?

How do I schedule a lab appointment at Northwestern?

How do I report an issue at Northwestern Medicine?

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People also ask

How much do Northwestern doctors make?

Related links

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