Physician Offices

Forms and Requisitions

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.

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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.

ABN Forms

 

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.

RML Requisitions

 

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.

Supply Requisition Form