PATHOLOGY Pay category (Pathology office use): Std. of To be paid by No. care Details (S) Sponsor (I) Insurer Item no. reqd. Cost Y/N (Please list all tests required, adding more rows where necessary) (P) Patient (C) Cabrini handling Preparation regime: IV medication: Oral medication: Type of service (please highlight): Self-collecting: Collection by Cabrini Pathology: Transport required: Comments: Department Head (name): Signed: Date:
PATHOLOGY Pay category (Pathology office use): Details (Please list all tests required, adding more rows where necessary) Item no. No. reqd. Std. of care Y/N Cost To be paid by (S) Sponsor (I) Insurer (P) Patient (C) Cabrini handling Preparation regime: IV medication: Oral medication: Type of service (please highlight): Self-collecting: Collection by Cabrini Pathology: Transport required: Comments: Department Head (name): Signed: Date:
Attachment-3-Project-Resourcing-and-Costing-Template-14-Oct-2015.docx