Massachusetts General Hospital



This template is to be used only to note processing/tube changes during the lab transition to QUEST period.LAB TRANSITION ORDERS for SPID ________ Visit #__________Date of Visit: ______________ Time: ______________ □ Outpatient □ Inpatient?Send all labs that were previously sent to LabCorp to MGH CORE LAB - All orders have been placed in Epic. See attached processing instructions ? Process labs for storage. See attached processing instructions Tubes to be drawn:MD/NP/PA Signature:_______________________ Print name: _____________________________Phone/Pager: _____________________________Tube: Indicate specimen type (urine/ blood/ CSF..), tube color, size and amountTest: Processing instructions:Special instructions:Storage/Send To:Name of test:Clot: Spin: Aliquot: Temp: Label each tube and aliquot with: Name, MRN, SPID#, V#, Tube, Test, Time pointName of test:Clot: Spin: Aliquot: Temp:Label each tube and aliquot with: Name, MRN, SPID#, V#, Tube, Test, Time pointName of test:Clot: Spin: Aliquot:Temp: Label each tube and aliquot with: Name, MRN, SPID#, V#, Tube, Test, Time pointName of test:Clot: Spin: Aliquot: Temp: Label each tube and aliquot with: Name, MRN, SPID#, V#, Tube, Test, Time pointName of test: Clot: Spin:Aliquot: Temp: Label each tube and aliquot with: Name, MRN, SPID#, V#, Tube, Test, Time point -45720031559500 ................
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