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
- Date of Birth
- 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.