How to Complete the ‘Requisition Form’ (found inside the test kit)

If you are unsure how to complete the requisition form found inside the test kit, open the applicable PDF below for an example of how to complete it. (If your test is not listed, view another PDF from the same lab to gain an idea of how to complete it).

 

DDI 2011

 

 

 

pdfComprehensive Stool Analysis (CSA) with Parasitology x3

pdfElemental Hair Analysis

pdfFecal Toxic Metals

pdfGluten Sensitivity Panel (serum)

pdfHepatic Detoxification Profile (HDP)

pdfRed Blood Cell Elements (RBC)

pdfUrine Amino Acids (UAA)

pdfUrine Halides; Pre & Post

pdfUrine Iodide (Pre & Post)

pdfUrine Porphyrins

 pdfUrine Toxic & Essential Elements

pdfVitamin D via Blood Spot

pdfWhole Blood Elements

 

 

US BioTek

 

 

 

pdfAntibody Assessment Panel – IgG/IgA General Foods (Blood Spot)

pdfEnvironmental Pollutants Panel (EPP)

pdfUrinary Metabolic Acids (UMP)

 

 

 

lipidlogo

 

 

 

pdfThe Holman Omega-3 Test

 

 

FAQs

I have already filled in my details when I ordered the kit - why do I have to fill in another form?

Each lab has a different requisition form and different requirements regarding information on you (the patient) and your sample. The information you have supplied when ordering your kit was for billing purposes only. The information on the requisition form is for the laboratory. It is important all sections on the requisition form have been completed to ensure there are no issues in processing your sample.

There are quite a few options on the requisition form and I am unsure what test I should select

Tip: Your practitioner most likely gave you a 'Pathology Request Form' for ordering your kit. If you are unsure which test to select on the requisition form, you can refer to what was marked by your practitioner on the Pathology Request Form.

I can see 'add-on panels' listed on my form but I am not sure if I should select them

Some requisition forms list optional 'add-on' panels. Please do not tick 'add-on' panels if you are unsure - this may mean additional cost to you. Checking what was marked by your practitioner on your Pathology Request Form may assist you. Otherwise, check with your practitioner what has been prescribed to you. Alternatively, Research Nutrition may be able to assist you by checking the billing amount you have been charged - you can contact us on 1800 110 158 during business hours.

The example forms listed on this page contains a section for payment information however I have already prepaid for my test when I ordered the kit

If you have prepaid the test when ordering the test kit, you do not need to enter payment information on the requisition form ('PAID' will be stamped in the payment area).

I am not sure if I should select 'Bill Practitioner''

Please only select 'Bill Practitioner' if you have paid your practitioner directly for the test and your practitioner has authorised you to select it. It means that your test will be charged to your practitioner's account.