Lafalaise 2026

1. Click ‘Get Form’ to open the lafalaise request form in the editor.
2. Begin by entering the patient's name, including surname and first name, in the designated fields. Ensure accuracy for proper identification.
3. Fill in the patient's address and telephone number. This information is crucial for contact purposes.
4. Input the date of birth using the provided format (M/D/Y). This helps in verifying age-related tests.
5. Next, enter the doctor's name and address. This section is important for referral purposes.
6. Select the specimen type by checking either Blood, Urine, or Swab as applicable.
7. Indicate the date and time when the sample was drawn and received. Accurate timestamps are essential for lab processing.
8. Check off each panel and individual test requested by marking an 'X' in the corresponding boxes. Review your selections carefully.
9. Complete any additional customer information required at the bottom of the form, including location details and fasting instructions if necessary.
10. Finally, ensure that both client and phlebotomist signatures are provided at the end of the form to validate consent.

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