Blood Test Lab Request Form

Access a helpful template for streamlining the process of requesting a blood test from a lab. Get a free Blood Test Lab Request Form here.

By Carepatron Team on Aug 2, 2025.

Fact Checked by Ericka Pingol.

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What is a Blood Test Lab Request Form?

A Blood Test Lab Request Form, also called a laboratory requisition form or a test request, is a document used by healthcare providers to refer a patient's blood sample for lab work. It serves as a crucial communication tool between a lab facility and a frontline healthcare department.

Blood tests are commonly used by medical professionals for a variety of reasons, including monitoring a patient's health or investigating their symptoms. Typically, healthcare providers must send the sample to laboratory services to perform analyses. A healthcare provider may request many types of blood tests, such as a complete blood count, a basic metabolic panel, or an electrolyte panel. Laboratory results are often essential to medical assessments and diagnoses.

Laboratory request forms facilitate the process of requesting specific tests by providing a systematic way to send all the required information to laboratories, such as patient details and sample information. Some forms also include fields for billing information. Following specimen collection, healthcare providers will send the completed form and sample to a lab for analysis. It is important that lab requisitions are completed accurately to ensure proper processing.

Blood Test Lab Request Form Template

Blood Test Lab Request Form PDF Template

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How to use our Blood Test Lab Request Form template

Here's how to use our free template:

Step 1: Access the template

Access the printable Blood Test Lab Request Form template using the link on this page.

Step 2: Fill in the recipient and requesting physician information

Fill in the essential details for the lab receiving the test request and the contact details for the healthcare provider making the request.

Step 3: Input patient information

Fill in the fields for the patient's essential information, such as their name, date of birth, and medical ID number. Include any important clinical details the lab may need to know, such as medications the patient is taking.

Step 4: Input sample details and test information

Record the sample number and the date and time of collection, as well as the person who performed the blood draw. Next, tick the checkboxes next to the tests you are requesting. Specify any further tests you need conducted in the 'other tests' field.

Step 6: Provide authorization details and send the completed form

Enter the date and the information of the physician who has authorized the request. Once the laboratory request form is complete with the required signatures, send it to the lab along with the sample and wait for the results.

Benefits of using Blood Test Lab Request Forms

A laboratory request form is a crucial component of efficient healthcare, facilitating a seamless process of requesting and performing bloodwork and returning results to healthcare providers. Here are some of the key benefits of using this template:

Convenience and time-saving

Creating a laboratory request form from scratch is time-consuming and risks missing important information that laboratories may require. By using a lab request form template, healthcare providers can easily and quickly ensure all the necessary information is provided to the lab and reduce the chance of errors. This allows the testing process to run smoothly and results to be returned as quickly as possible.

Efficient communication

Test request forms help healthcare providers communicate the tests required as well as additional information and administrative data. It also provides a concise and organized record of the tests that have been requested on behalf of a patient to have on file.

Fully digital

The Blood Test Lab Request Form template is designed for convenience and ease of use. Whether you save the PDF digitally or print a hard copy, this template can be filled and delivered however you prefer.

Commonly asked questions

Laboratory request forms are used by healthcare professionals when they need lab tests conducted to help assess patients' health or diagnose medical conditions. These forms are sent with a patient's sample (e.g. blood or urine) to a lab for analysis.

It is vital that the request contains both patient information and contact details for the medical professional making the request, as well as the tests required and identification information for the sample. Lab request forms with missing or incomplete data can result in delays or mix-ups that impact the quality of care.

Blood Test Lab Request Forms are used whenever a medical professional refers a patient's blood sample to a lab for testing. Lab requisition forms are necessary to indicate which types of blood tests are required.