Microbiology Request Form - gov pe 2026

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  1. Click ‘Get Form’ to open the Microbiology Request Form in the editor.
  2. Begin by entering your personal information, including your name, address, and contact details. Ensure that you provide accurate information for effective communication.
  3. Fill in the specimen collection date and time. This is crucial for tracking and processing your request efficiently.
  4. Indicate the relevant clinical information and any current antibiotics being taken. This helps the laboratory understand your medical context.
  5. Select the appropriate tests required by checking the corresponding boxes. Be thorough in specifying sources and types of cultures needed.
  6. Review all entered information for accuracy before submitting. Use our platform’s features to save or print a copy for your records.

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2021 4.8 Satisfied (112 Votes)
2017 4.1 Satisfied (55 Votes)
2013 4.3 Satisfied (48 Votes)
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What Patient details (name, address, telephone number, birth date, gender, etc.) Requester details. Type of primary sample. Examination(s) requested. Clinical information relevant to the laboratory. Date, time and place of sample collection. Date and time of receipt of the sample at the laboratory.
The laboratory request form provides the outside laboratory with information needed to test the specimen. The clinical diagnosis is indicated on a laboratory request to correlate laboratory data with the needs of the physician.
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