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- Click ‘Get Form’ to open the Great Plains Laboratory Test Requisition Form in the editor.
- Begin by filling out the 'Patient Information' section. Ensure all fields marked in RED are completed, including first name, last name, address, and date of birth.
- Next, provide details for the 'Person Responsible for Charges' if different from the patient. Include their contact information clearly.
- In the 'Physician Information' section, enter the physician's details and ensure their signature is included to process the sample.
- Complete the 'ICD-9 Codes' and select your method of payment under 'Method of Payment & Insurance Information'. Make sure to include any necessary insurance documentation.
- Fill out the 'Test Orders' on the reverse side of the form. Specify which tests are being requested and any relevant collection dates and times.
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