Notice: Please ensure that we have all updated facesheets. Facesheets can be emailed to facesheets@aculabs.com. This information will be required to make Online Order Entry as quick and efficient for your nursing staff as possible. It may be easier to allow us access to your EMR. 

Please ensure that all files are properly compressed and appropriately encrypted before sending. 

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      Facility Info

    • 2

      Staff Info

    • 3

      Nursing Staff

    • 4

      Unit Info

    • 5

      Billing Info

    • 6

      Notice

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    Facility Info

    Facility Contact Information







    0%

    Administrator Information


    Director of Nursing Information


    Business Office Information


    IT Department Information


    20%

    Assistant Director of Nursing Information


    Staff Educator Information


    Infection Control Contact's Information


    40%

    Facility Unit Information



    Specimen Fridge Information

    60%

    Face Sheet Information


    Invoice Information


    Accounts Payable Information


    EMR System Information

    Can we have access to your EMR system? (required)


    Your EMR System (required)
    PointClickCareSigmaCareOther

    If "other", please specify what EMR system you use (required)

    Payor Type Information

    Do you have Part A Days? (required)
    Do you HMO Days? (required)

    Daily Census Information


    Monthly Census Information



    Bed Type Information

    Do you have AL and/or IL beds? (required)
    Do you have an ABN on File for Medicare Part B patients? (required)
    (If not, click here to download our blank ABN form)

    80%

    Placing Standing Orders

    Do you have standing orders?

    Notice: It is vitally important that the standing orders indicate the months the orders are to be drawn. If the list of standing orders does not include dates, it will be necessary to ascertain the dates or make a decision on what dates you wish us to input all of your reoccurring orders. It will be important to make sure the laboratory orders we receive coincide with your physician’s orders.


    Submitting Physician Information

    Please ensure your file is in .pdf, .doc, or .docx format and under 5MBs in size.


    To help assist us as much as possible, please be aware that you'll need to assemble a listing of information you have on relevant physicians. This listing should include physicians' names, addresses, phone numbers, fax numbers, and NPI numbers. You may submit it as an attached document for convenience.


    100%