CNS TESTING'S LAB TEST REQUISITION FORM

Convenient Online Lab Form

Need to submit a CNS Testing lab order form for your patient? 

CNS allows you to conveniently submit your lab orders electronically that is HIPPA compliant OR you fil out our lab form in an downloadable fillable PDF format. Electronic submission is the easiest and quickest method. You just fill out the form, sign and submit. You can also print an e-copy for your records. For paper forms: Complete, sign, and fax to us. Either way, you choose!

For frequent provider/clinic ordering, contact our office to setup an account for easy ordering.

Lab Form in Fillable PDF format to download, type, sign, print and send.

Submit and send your lab requisition from online. It's easy, fast and HIPPA compliant!

- Note: Requires ordering provider to sign and date electronically.

*Learn more about our Covid-19 and Flu  rapid tests by clicking HERE. Testing with COVID-19 "Coronavirus" IgG/IgM Rapid tests should only be performed in conjunction with other laboratory approved testing and/or clinical observations for the presumptive identification of viral infections in patients who may be infected with 2019nCoV (detected in China in 2019).

SAMPLE LAB REQUISITION FORM & INSTRUCTIONS (paper format)

CNS Testing – Lab Requisition Form - SAM
CNS Testing – Lab Requisition Form - SAM

CNS Covid-19 and Flu A/B testing includes a non-invasive, quick health screening.

HEALTH SCREENINGS, includes:

Vital signs checks:

  1. Temperature

  2. Pulse ox

  3. Respirations

  4. Blood pressure

  5. Pulse rate

 

Review of various human body systems commonly suspected to be related to Covid-19 and specific for client symptoms. Ex.

  • Respiratory system check by assessing respiratory status.

  • Musculoskeletal system check for pain and muscle aches.

  • And, many more body systems, such as nervous system, endocrine system, cardiovascular system, lymphatic system, digestive system and urinary system. 

*INSURANCE NOTE:

According to the CARES Act, Covid-19 testing, including antibody testing and diagnostic flu testing, can be covered by your health insurance provider. However, every person's health insurance plan is different. So, clients need to contact their insurance benefits provider to see if they are covered. Most insurance plans require a provider's order for coverage eligibility.

If clients have a provider's order for your lab test(s), then CNS will bill their insurance first. We are an out-of-network private medical lab testing company, so clients will need to contact their insurance provider first to check if they are covered. If the insurance company will not cover the cost of testing, then clients will receive a bill and pay out-of-pocket.

 

If clients do not have a provider's order for a lab test, then all lab testing costs must be prepaid out-of-pocket by the client upon final booking. Then, they have the option to submit the cost of testing to their insurance company for reimbursement. CNS will not bill insurance without a provider's order.

 

Pricing is all-inclusive. There are no hidden costs and lab testing rates include testing, travel AND health screening.

 

CNS accepts all major credit and debit cards for online payments. CNS also accepts FSA and HSA cards with a VISA or Mastercard logo. Please contact your insurance benefits provider to verify plan rules and eligible expenses.

Submit and send your lab requisition from online. It's easy, fast and HIPPA compliant!

- Note: Requires ordering provider to sign and date electronically.

*Learn more about our Covid-19 and Flu  rapid tests by clicking HERE. Testing with COVID-19 "Coronavirus" IgG/IgM Rapid tests should only be performed in conjunction with other laboratory approved testing and/or clinical observations for the presumptive identification of viral infections in patients who may be infected with 2019nCoV (detected in China in 2019).