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1. Click ‘Get Form’ to open it in the editor.
2. Begin with the 'Patient Information' section. Fill in the patient's name, gender, date of birth, personal health number, and contact details. Ensure all fields are completed to avoid processing delays.
3. Next, move to the 'Referring Physician Information'. Enter the physician's name, phone number, fax number, and email address.
4. In the 'Referring Laboratory Information', provide the laboratory name and contact details. Specify the sample type and collection date.
5. Choose your billing option under 'Billing Options and Receiving Results'. Select either Option A for referral laboratory billing or Option B for direct customer payment. Fill in any required customer information if you choose Option B.
6. Review all entered information for accuracy before submitting. Use our platform’s features to save or print a copy of your completed form.

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