Make an Outpatient Referral
To make an outpatient referral to an approved laboratory facility for an insured laboratory test, complete the following steps:
- Use the Standard Outpatient Laboratory Requisition (SOPLR) form, or equivalent, and complete the ordering practitioner, address and MSP practitioner number box located on the upper right hand side of the form. This information directs the laboratory test results to the appropriate ordering practitioner and work site.
- If copies to a physician are required, complete the copy to physician/MSP practitioner number section located on the upper right hand side of the SOPLR form.
- Complete the surname of patient, first name of patient, date of birth, sex, and the personal health number (PHN) sections.
- Refer to the RN(C) Test Ordering Chart to select the appropriate box(es) on the requisition for the test or tests being ordered, or use the free text box.
- Sign and date the form before providing it to the patient.