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TEST REQUISITION FORM Cytogenetic Laboratories - IU Health

TEST REQUISITION FORM Cytogenetic Laboratories - IU Health 2025

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The document is a Constitutional Blood Test Requisition Form from Cytogenetic Laboratories at Indiana University School of Medicine. It outlines the necessary information for ordering genetic tests, including patient and physician details, clinical information, requested testing types, financial authorization for insurance billing, specimen collection and handling requirements. The form is designed to facilitate the submission and processing of blood samples for various genetic analyses.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (34 Votes)
2015	4.3 Satisfied (221 Votes)
2014	4.4 Satisfied (183 Votes)
2013	4 Satisfied (58 Votes)

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How long does cytogenetic test take?

The scan is painless but you need to lie still, which may be a bit uncomfortable. The scan usually takes between 15 minutes and an hour.

What are the 5 items that should be included on a lab requisition form?

Laboratory Test Requisition (Outreach) Specimen Information. Include Date and Time Collected and initials of the person who collected the specimen. ... Patient Information. ... Insurance Billing Information. ... ICD-10/Dx Code. ... Patient Authorization. ... Test Orders. ... Advance Beneficiary Notice (ABN)

What is the purpose of a lab requisition form?

What is a lab requisition form? A lab requisition form is used by healthcare professionals to request laboratory tests such as urine or blood testing. They are also called test requisition forms. When blood, urine, or tissue is sent to a lab from a doctor's office a lab requisition form is required.

How long does it take for chromosome analysis to come back?

The picture of the chromosomes is called a karyotype (CARE-ee-o-type). Results will be available to patients in 4 weeks.

What is the requisition form?

The most common definition of a requisition form is a formal request for an item or service. Companies use the document to stay on top of any items procured by the organization. Typically, you must submit a requisition form to kick off the process of making a purchase and to have a record of the request.

What is the purpose of lab requisition?

A lab requisition form is used by healthcare professionals to request laboratory tests such as urine or blood testing. They are also called test requisition forms. When blood, urine, or tissue is sent to a lab from a doctor's office a lab requisition form is required.

What is a test requisition?

The Test Requisition Form This form contains critical information about the patient, ordering physician, ordered tests, and insurance data.

What needs to be on a lab requisition?

The laboratory test request must provide the following information: Ordering provider's full name, address, phone number, and provider signature. Patient's name and date of birth. Test(s) requested.

TEST REQUISITION FORM Cytogenetic Laboratories - IU Health 2025

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How long does it take for chromosome analysis to come back?

What is the requisition form?

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What is a test requisition?

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TEST REQUISITION FORM Cytogenetic Laboratories - IU Health 2025

Here's how it works

How to edit TEST REQUISITION FORM Cytogenetic Laboratories - IU Health online

See more TEST REQUISITION FORM Cytogenetic Laboratories - IU Health versions

Complete this form in 5 minutes or less

Got questions?

How do I sign my [KEY] free of charge?

Do I need to set up software to edit my [KEY]?

How long does cytogenetic test take?

What are the 5 items that should be included on a lab requisition form?

What is the purpose of a lab requisition form?

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People also ask

How long does it take for chromosome analysis to come back?

What is the requisition form?

What is the purpose of lab requisition?

What is a test requisition?

What needs to be on a lab requisition?

Related links

Try more PDF tools