PL Bulletin

Requisition Requirements

Posted by: Amanda Stanley

Proper completion of requisition forms is essential for correct and timely processing, resulting, and billing of patient samples. The following is a list of elements required for all requisition forms.


  • Patient’s Full Name
  • Address
  • Date of Birth
  • Sex
  • Name of Submitting Facility
  • Name of Physician
  • Clinical History
  • Insurance and/or billing information
  • Date of Collection
  • Source of Specimen
  • Place of service, e.g. inpatient or outpatient if from a hospital


Do not hesitate to contact Physicians Laboratory with any questions regarding specimen submission.