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Phlebotomy Procedure

Laboratory Test Request

Numerical OrderProcedure
1 Guidelines Patient identification (ID) (name, unique registration or identification number, and location, unique confidential specimen code that has an audit trail to the patient)
2 Guidelines Patient's gender & DOB or age
3 Guidelines Name of physician or legally authorized person ordering the test (the physician's address is needed if it's different than the receiving laboratory)
4 Guidelines Tests requested
5 Guidelines Date and, when appropriate, time of sample collection
6 Guidelines Source of sample, when appropriate
7 Guidelines Other pertinent clinical information when appropriate
Created by: DenmarkH0ttie
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