Laboratory Clinical Test Request Form

Form Template

Use the Laboratory Clinical Test Request Form mobile app to request specimen clinical lab tests.

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Use the app for each separate specimen. All specimens must be labeled with patient name and date of collection. The app records: Specimen Information, Clinical Laboratory/Practice Information, Patient Information, Billing Information, Specimen Type, Bacteriology, Bacterial Typing/Fingerprinting, Mycobacteriology, Parasitology, Serology, Toxicology, Virology and Comments. It is extremely easy to load the saved state of a GoCanvas app.

Features
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

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