<<Disclaimer: Verify this information before applying it to your situation.>>
Put your request for testing in writing, including the specific tests you
are asking for and the reasons for your request. Be specific, but brief
(see example below). Ask your doctor to sign it. Make a copy & ask him to
keep one in your file and keep one for yourself.
No doctor in his right mind will refuse, because if you find out at a later
date that you DO have the disease you requested screening for and he refused
order tests, he could be liable for damages. It's easy for a doctor to
refuse if there's no documentation of your request, because he can simply
deny you ever requested it. But if you nail it down in writing & keep a
dated copy with his signiature, you've got him by the short hairs. This
works especially well for pediactric patients.
Example below. Valerie in Tacoma
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June 23, 2005
I, Betty Pooped, am requesting Dr. Blank order a complete thyroid panel to
screen me for hypothyroidism for the following reasons:
(1) Family history (mother, sister, grandmother all hypothyroid)
(2) Related condition(s): celiac disease, Lupus, diabetes
(3) I am experiencing the following symptoms: feel cold when everyone else
is warm, dry skin, thinning, dry hair, indigestion, lack of energy &
motivation, more frequent constipation than previously, loss of outer third
of eyebrows, puffiness around eyes, leg & foot cramps, recent unexplained
weight gain of 20 pounds.
_______________________(your signature)
Physician signature____________________________date______________
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