Medical and Diagnostic Laboratories Forms for Pima
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FAQ
A Close Look at Custom Requisition Forms For laboratories, a lab requisition form is a written request for a medical test or procedure. It is written by a doctor or medical facility, and then fulfilled at the lab.
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.
Requisition forms typically include the name of the person making the request, the date of the request, items requested, the delivery date, the delivery location, and the department responsible for fulfilling the request.
The essential elements of the requisition form are:Patient's surname, first name, and middle initial.Patient's ID number.Patient's date of birth and sex.Requesting physician's complete name.Source of specimen.Date and time of collection.Initials of phlebotomist.Indicating the test(s) requested.
Name, address, phone # of lab, physician's name and address, patients name, age and gender, patient accession #, date specimen is received, date results were reported, name of tests performed, results of tests, reference range for each test performed.
Medical Laboratory Technicians (MLT) are vital to the healthcare team as they are often the first to produce patient results. MLTs use sophisticated biomedical instrumentation, as well as manual procedures, to perform testing and provide results that are essential in the diagnosis, treatment, and prevention of disease.