How to Complete a Test Request Form
Please use a suitable form when requesting a test. These can include:
- Forms generated from your patient software system. Please contact Wellington SCL’s customer liaison coordinator for instructions on the best lay-out for the form.
- Standard Wellington SCL test request forms with pre-printed personalised requestor codes. These are available from the laboratory. Ask our customer liaison coordinator to send you some.
- Special request forms designed for you by Wellington SCL for a particular need; for example for a study, survey or business need.
To help turn around results quickly, test request forms should be filled out correctly and completely with clear legible handwriting.
A request form requires the following information:
- Full name of patient — last name and first name
- Date of Birth
- Patient’s address
- Requesting doctor’s name
- Name of copy-to doctors — specify last name and location
- Tests required
- Relevant clinical information and/or indications for testing
Additional information required for a serial test request:
- Frequency of testing for specified tests — for example, monthly, three-monthly
- Duration of testing.