Botsford Hospital
28050 Grand River Ave.
Farmington Hills, MI 48336-5919
(248) 471-8000
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Outreach Lab


Requisition and ICD9

To better serve the patients and clients, it is essential that accurate and legible demographic, insurance and test information is provided to Botsford Hospital. Any deficiency in the data will result in delayed sample analysis and potential billing problems, with follow-up telephone calls and documentation to the physician office. This section explains the proper procedure for completing requisitions. Any questions concerning requisitions should be directed to the Customer Service Representatives.

Site sending paper Laboratory Requisition form must have the following information:

Laboratory Requisition

Pathology Requisition