Great plains laboratory test requisition form 2026

1. Click ‘Get Form’ to open the Great Plains Laboratory Test Requisition Form in the editor.
2. 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.
3. Next, provide details for the 'Person Responsible for Charges' if different from the patient. Include their contact information clearly.
4. In the 'Physician Information' section, enter the physician's details and ensure their signature is included to process the sample.
5. 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.
6. 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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