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Form Instructions 8801 for Pittsburgh Pennsylvania: What You Should Know

A completed test request form is required to perform testing to make a determination. Affix a patient information label to the test request form or fully complete the information. Submit: 1. Completed test request form (see enclosed form). 2. Patient information form and test information form (see enclosed forms) 3. For a medical test,  4. Sample forms for sample instructions and lab sheets,  5. Test form, 6. Laboratory forms and test sheets or laboratory instructions 7. Lab and patient's report (see enclosed forms) The following are the criteria for eligibility for testing: A. Physical Examination 1. A physical examination must include: (2) A skin temperature of 40.6 or higher (3) A bowel movement of 6.9 g or more (5) (3) Breath sounds and heart sounds (1) A complete examination including evaluation of an individuals physical and mental general Physical and Mental Function B. Laboratory Tests 1. All lab tests require the following: (2) 1. Any lab tests are conducted at the facility which the report was prepared and performed by any laboratory having in effect a policy that prohibits receipt by an individual of the results, or data obtained, the test is performed. 2. A patient must receive a copy of the lab test and, in the case of some tests, a copy of the clinical test report in order for the reporting agent to make a determination. 3. For a test or specimen listed under Subsections (B)(v)-(vi): a. Results and data must be available within 24 hours of the laboratory test to which the request is directed by the Reporting Agent (3) The following test or specimen is not eligible for release: 4. All tests are performed by: a.  — All laboratory records must be stored in accordance with State law and the rules, rules adopted by the state laboratory, and must be available for inspection and copying by the Reporting Agent or by an individual upon request, Note: Each laboratory's policies and procedures must be publicly available for inspection, so the public can know whether the requested test result and clinical test report meet certain criteria  a.

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