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Click ‘Get Form’ to open the general laboratory requisition form in the editor.
Begin by entering the patient's name and medical record number at the top of the form. This information is crucial for accurate identification.
Fill in the provider's name, fax number, phone number, and address. Ensure that the address is complete, especially for HIV result notifications.
Specify the culture source and any standing order frequency if applicable. This helps streamline testing processes.
In the test section, check off all relevant tests required for your patient. Be sure to include ICD-10 codes where necessary to comply with billing requirements.
If additional tests are needed, utilize the 'List Other Tests' section to specify them along with their corresponding ICD-10 codes.
Finally, review all entries for accuracy before saving or exporting your completed form for submission.

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Versions	Form popularity	Fillable & printable
2016	4.6 Satisfied (21 Votes)
2008	4 Satisfied (31 Votes)

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How to create a lab requisition form?

To request the purchase of goods or services: A requisition form is used by your company to request the purchase of goods or services from a vendor. The form typically includes information about your requested goods or services, the quantity needed, and the estimated cost.

What is a lab requisition form?

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.

What is a general laboratory requisition?

What is a General Laboratory Requisition Form? General laboratory requisition forms are used by physicians when performing comprehensive medical tests as part of routine checkups, diagnoses and benchmarking new patients.

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