Coagu check physician order form 2026

1. Click ‘Get Form’ to open the coagu check physician order form in the editor.
2. Begin by filling out the patient information section. Enter the patient's first name, last name, date of birth, gender, and contact details including primary and secondary phone numbers.
3. Complete the patient diagnosis code section by entering all applicable codes from the provided list. Ensure that you only include covered diagnosis codes to avoid processing delays.
4. In the medical information section, indicate whether the patient has been on warfarin therapy for more than three months and specify the therapeutic INR ranges.
5. Fill in the contact information for receiving test results, including preferred methods such as fax or online through CoaguChek Link.
6. Finally, ensure that the prescribing physician signs and dates the form. Include their printed name and contact details before submitting it via mail or fax.

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