Outpatient Laboratory Requisition Form 2026

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4.8 out of 5

233 votes

The document is an Outpatient Laboratory Requisition form that outlines the necessary information and procedures for patients undergoing laboratory tests. It includes sections for patient details, ordering physician information, test selections across various categories (hematology, chemistry, microbiology, etc.), and instructions for both patients and laboratory staff. The form emphasizes the importance of completing highlighted fields to prevent delays and provides guidelines for specific tests, including fasting requirements and special instructions.

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Click ‘Get Form’ to open the Outpatient Laboratory Requisition in the editor.
Begin by filling out the 'Ordering Physician' section, ensuring you include your address and MSP practitioner number for accurate processing.
Complete the 'Patient' details, including surname, first name, PHN number, and date of birth. Highlighted fields are mandatory to avoid delays.
Indicate any special instructions such as 'STAT order' by providing a contact telephone number if necessary.
Fill in the relevant tests required by checking the appropriate boxes under Hematology, Chemistry, Microbiology, and other sections as needed.
Finally, ensure that you sign and date the form at the bottom before submitting it through our platform for processing.

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Versions	Form popularity	Fillable & printable
2016	4.8 Satisfied (233 Votes)
2011	4.5 Satisfied (40 Votes)

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