Final answer:
On an outpatient blood collection requisition form, the required information includes patient information, relevant medical history, reason for blood collection, date and time of collection, healthcare provider information, and consent.
Step-by-step explanation:
On a requisition form for an outpatient blood collection, the following information is typically required:
- Patient information: This includes the patient's full name, date of birth, address, and contact information.
- Relevant medical history: This may include information about any medications the patient is currently taking, any pre-existing medical conditions, or any recent surgeries.
- Reason for the blood collection: The healthcare provider needs to know why the blood is being collected and what specific tests or analysis will be performed on the blood sample.
- Date and time of collection: This helps with accurate record-keeping and allows for proper tracking of the sample.
- Healthcare provider information: This includes the name, contact information, and signature of the healthcare provider who ordered the blood collection.
- Consent: The patient often needs to provide consent for the blood collection to be performed.