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Develop a Request Form that at least includes room for at least the following information: 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.
How to fill out a requisition form?
Laboratory Instructions for Completion of Routine Request Forms Enter first and last name. Enter phone and fax numbers for handling of results. Patient Information. Please print clearly, using a pen. Enter patient last name, suffix (Jr., Sr., III), first name, middle initial. Mark sexM or Fmany tests are sex-related.
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