Downloads
November 30, 2012 - Important Memo..!Regional Medical Laboratory strives to keep you up to date with important changes or news items in the healthcare system. We have recently released an important memorandum that contain information concerning the New Medicare Administrative Contractor for Oklahoma.
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Patient requisitions and other forms, such as advanced beneficiary notice (ABN) and supply order forms, are available at no additional charge to our clients. For quick delivery, requests maybe faxed to (918) 744-3006. Some forms are available to download from this section. Select the form from the menu on the right of the screen.
ABN (Advanced Beneficiary Notification Form)
The Hyperlinks below will provide a easy to view and printable ABN form. Once open click the Printer Icon on the left side in the toolbar just above the form.
Printable ABN form (English)
Printable ABN form (Spanish)
View ABN Instructions
Alert Values
The Hyperlinks below will provide a printer friendly alert values pages. Once open click the Printer Icon on the left side in the toolbar just above the form.
Alert Values
Allergy Panels
The Hyperlinks below will provide a printer friendly allergy panels. Once open click the Printer Icon on the left side in the toolbar just above the form.
General Allergy Panels
Allergist Specific Panels
Antibiograms
Our hospital antibiogram data measures the regional biological resistance to antibiotics of substances causing disease and allows prior knowledge of the effectiveness of drug therapy so as to make it more efficient. *(Revised)
Billing Services Forms
The Hyperlinks below will provide a easy to view and printable version of helpful billing forms. Once open click the Printer Icon on the left side in the toolbar just above the form.
Physician Request to Bill Patient
Physician Request to Bill Physician
Physician Request to Change Diagnosis
CommunityCare Genetic Testing Information
CLIA and CAP Certificates
The Hyperlinks below will provide a easy to view and printable CLIA and CAP certificates for Regional Medical Laboratory (RML) and Pathology Laboratory Associates (PLA). Once open click the Printer Icon on the left side in the toolbar just above the certificate. Click here for more information.
Printable RML certificates
Printable PLA certificates
Coagulation Forms
Patient Questionnaire
The Hyperlink below will provide a easy to view and printable Coagulopathy Questionnaire. Once open click the Printer Icon on the left side in the toolbar just above the form.
Coagulopathy Questionnaire Form
Specimen Processing - Double Spin Procedure
The Hyperlink below will provide a easy to view and printable Coagulation Double Spin Procedure. Once open click the Printer Icon on the left side in the toolbar just above the form.
Coagulation Double Spin Procedure
Cystic Fibrosis Forms
The Hyperlinks below will provide a easy to view, and printable Cystic Fibrosis Patient Information Sheet and Consent form. Once open click the Printer Icon on the left side in the toolbar just above the form.
CF Consent form
CF Patient Information form
Lead Collection Form
The Hyperlink below will provide a easy to view and printable Lead testing information form. Once open click the Printer Icon on the left side in the toolbar just above the form.
Lead Specimen Collection Form
Medical Information Release Authorization
The Hyperlink below will provide a easy to view and printable Medical Release Authorization form. Once open click the Printer Icon on the left side in the toolbar just above the form.
Medical Information Release
MSDS Information
A material safety data sheet or MSDS is a form containing data regarding the properties of a particular substance. An important component of workplace safety, it is intended to provide workers and emergency personnel with procedures for handling or working with that substance in a safe manner, and includes information such as physical data (melting point, boiling point, flash point, etc.), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill handling procedures. Click on the links below to reference the MSDS sheets for the materials you may come into contact with specimen collection.
Oncology, Flow Cytometry Work-up Requisition
The Hyperlink below will provide a easy to view and printable Oncology Work-up Requisition. Once open click the Printer Icon on the left side in the toolbar.
Oncology Work-up Requisition
Cytogenetics is the study of chromosomes and the related disease states caused by numerical and structural chromosome abnormalities. A several cell or tissue types can be useful to obtain chromosome preparations required in the assay. These samples include peripheral blood, bone marrow, amniotic fluid, and products of conception. Although specific techniques differ according to the type of specimen used, the basic method for obtaining a chromosome preparation is similar.
Fluorescent IN SITU Hybridization (FISH) is a relatively new technology utilizing fluorescently labeled DNA probes to detect or confirm gene or chromosome abnormalities that are generally beyond the resolution of routine Cytogenetics. The sample DNA is first denatured, a process that separates the complimentary strands within the DNA double helix structure. The fluorescently labeled probe of interest is then added to the denatured sample mixture and hybridizes with the sample DNA at the target site as it reforms itself back into a double helix. The probe signal can then be seen through a fluorescent microscope and the sample DNA scored for the presence or absence of the signal.
Pathology Slide Request Form
The Hyperlink below will provide a easy to view and printable Pathology Slide Request form. Once open click the Printer Icon on the left side in the toolbar just above the form.
Slide Request form
Prenatal Diagnosis Information
The Hyperlink below will provide a easy to view and printable Prenatal Diagnosis Information form. Once open click the Printer Icon on the left side in the toolbar just above the form.
First Trimester form
Second Trimester form
PTH / Calcium Graph
The Hyperlink below will provide a easy to view and printable PTH / Caclium Graph to help interpret your patient's results. Once open click the Printer Icon on the left side in the toolbar just above the form.
PTH / Calcium Graph
Reference Ranges
The Hyperlinks below will provide an easy to view and printable document. Once open click the Printer Icon on the left side in the toolbar just above the form.
Adult Reference Ranges
Age Related Reference Ranges
RML Requisitions
The Hyperlink below will provide printer friendly RML requistion. Once open click the Printer Icon on the left side in the toolbar just above the form.
Clinical Requisition.
Anatomical Pathology Requisition
Requisition Instructions
The Hyperlink below will provide printer friendly instructions on filling out the RML requistion. Once open click the Printer Icon on the left side in the toolbar just above the form.
Requisitions Instructions
Stone Risk Patient Information
The Hyperlink below will provide printer friendly RML Stone Risk Patient Information form. Once open click the Printer Icon on the left side in the toolbar just above the form.
Stone Risk Patient Informaion form *revised
Stool Collection Containers
The Hyperlink below will provide a easy to view and printable Stool Collection devices for the various microbiology tests performed on stool including occult blood testing. Once open click the Printer Icon on the left side in the toolbar just above the form.
Stool Collection Containers
Occult Blood Stool Collection
Supply Requisition Form
RML will provide supplies for your testing needs. Routine deliveries arrive on a scheduled basis. The Hyperlink below will provide a easy to view and printable RML Supply Requisition form. Once open click the Printer Icon on the left side in the toolbar just above the form. Supply requests may be faxed directly to our Materials Management Department.
(918) 744-3006 or (888) 833-0528
Urine Collections, 24hr. Preservatives
The Hyperlink below will provide a easy to view and printable Urine collection and Preservative reference sheets. Once open click the Printer Icon on the left side in the toolbar just above the form.
Regional Medical Laboratory