ChildLab Requistions

REQUISITION INFORMATION

The ChildLab provides a test requisition form to clients for specimen referral and patient referral. The test requisition form combines patient registration information, test requisition information and a physician order for confirmation of testing.
The requisition form should be completed by the physician or authorized staff and signed by the ordering physician. Please assure accuracy of patient information. Questions or concerns regarding completion of forms can be directed to (614) 722-5477 or (800) 934-6575. To set up an account and receive requisitions, please select New Client Form. If you are an existing client and need requisitions, please select Supply Order form.

SPECIMEN REFERRAL

Daily COURIER SERVICE for routine and STAT pick-up of specimens is available to clients within the Columbus area. For clients located outside the Columbus area, courier arrangements will be made with the most efficient courier such as Federal Express, United Parcel Service, U.S. Mail or ground courier. Contact Client Services at (614) 722-5477 or (800) 934-6575.

PATIENT REFERRAL

Patients referred to any of our locations should present a physician order for laboratory testing. A ChildLab Test Requisition may be used or a physician script may be used. Any Cytogenetics requests must use the Cytogenetics requisition. Please contact the ChildLab for information:(614) 722-5477 or (800) 934-6575. The physician script must provide the following information:

Ordering physician's full name, address, phone number and signature
Patient's name and date of birth
Tests requested
Diagnosis and/or ICD-9 Codes
Date and time of order
Additional information

Other necessary information relevant to testing will be obtained by laboratory personnel.

VERBAL REQUESTS

Verbal requests for laboratory tests can be telephoned to any of our locations by the physician or authorized office staff. Federal regulations require CONFIRMATION OF VERBAL REQUESTS FOR LABORATORY TESTING WITH A WRITTEN PHYSICIAN ORDER WITHIN 30 DAYS OF TESTING. Confirmations must include the following information:

Patient identification (name and MR# or date of birth)
Requested tests
Date of testing
Physician signature

A Physician Confirmation of Verbal Request for Laboratory Tests form will be sent to the ordering physician's office. The order must be signed and returned to the laboratory within 30 days. Click here to see an example of the form.

CLIENT STAFF TRAINING

Client staff training is available for capillary puncture technique, microbiology and virology specimen collection and processing, and other requested topics.