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How do I fill this out?
To fill out the form, start by entering your practice details at the top. Next, provide the contact person's information and choose the forms you need. Finally, indicate the quantity for each type of requisition form.
How to fill out the Sentara Reference Lab Solutions Requisition Order Form?
1
Enter the client code and date.
2
Fill in the practice name, contact person, email, phone, and address.
3
List up to 10 providers along with their NPI numbers.
4
Select the type and quantity of requisition forms you wish to order.
5
Submit the completed form via fax or email.
Who needs the Sentara Reference Lab Solutions Requisition Order Form?
1
Patients who require lab tests ordered by their healthcare provider.
2
Healthcare practices that need to streamline their lab requisition process.
3
Nursing homes that require lab services for their residents.
4
Women's health clinics needing specific requisition forms.
5
Allergy clinics ordering specialized lab tests.
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1
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Make necessary changes to the information.
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What are the instructions for submitting this form?
To submit the requisition form, please either fax it to 757-388-1942 or send it via email to LabCustomerSvcs@sentara.com. Be sure to include all required fields fully completed to avoid delays. Allow 5-7 business days for delivery of the ordered forms after submission.
What are the important dates for this form in 2024 and 2025?
Important dates for this form may vary. Be sure to check for any updates or revisions in 2024 and 2025. Prepare accordingly to ensure timely submissions.
What is the purpose of this form?
The purpose of this form is to facilitate the ordering of laboratory services efficiently. It provides a clear structure for practices to request various types of lab requisitions. This ensures that healthcare providers have access to necessary testing solutions quickly and accurately.
Tell me about this form and its components and fields line-by-line.
- 1. Client Code: Unique code identifying the client.
- 2. Date: The date the order is being submitted.
- 3. Practice Name: The name of the healthcare practice.
- 4. Contact Person: The individual to contact regarding the order.
- 5. Email Address: Contact email for further communication.
- 6. Address: The physical address of the practice.
- 7. Providers and NPI #: List of providers and their NPI numbers.
- 8. Type and Quantity of Forms: Indicate the forms to order and their quantities.
What happens if I fail to submit this form?
If you fail to submit this form, it may delay the laboratory testing process. It's essential to ensure all fields are accurately filled before submission. Missing submissions can lead to gaps in patient care.
- Delayed Testing: Failure to submit on time can postpone necessary lab tests.
- Inaccurate Information: Errors in submission may result in receiving incorrect lab results.
- Communication Issues: Not submitting can lead to a lack of follow-up from the lab.
How do I know when to use this form?
- 1. Regular Lab Tests: Submit for routine testing needed by your practice.
- 2. Specialized Testing: Use when specific tests are required for patient diagnosis.
- 3. Annual Health Checkups: Ideal for ordering multiple tests during annual evaluations.
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What information is required on the form?
Ensure to include your practice details, contact info, and type of requisition needed.
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Is there a limit to the number of providers I can list?
You can list up to 10 providers on the requisition form.
What types of requisition forms can I order?
Options include general reference, women's health, allergy, and COVID requisition forms.
How do I submit the completed form?
Submit via fax or email as indicated on the form.
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Yes, you can print the PDF after making your edits.
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