Get the free Urovysion Requisition Form-Cytogenetics - the UCLA Department of ... - pathology ucla

Procedure: CATO 012 Effective: 7/25/12 PROVISION REQUISITION FORM CYTOGENETICS Please provide all pertinent information UCLA Cytogenetics Lab accession number: PATIENT INFORMATION ID # SPECIMEN INFORMATION

How to fill out urovysion requisition form-cytogenetics

How to fill out urovysion requisition form-cytogenetics:

1. Start by providing your personal information, including your name, date of birth, and contact details. Ensure that all the information you provide is accurate and up to date.
2. Next, indicate the reason for requesting the urovysion cytogenetics test. This could be for the diagnosis or monitoring of a specific medical condition relating to the urinary tract.
3. Specify the healthcare provider or physician who will be responsible for interpreting the results of the test. Include their name, contact information, and any additional details required.
4. Indicate the date and time of specimen collection. This ensures that the laboratory knows when the sample was taken and can process it accordingly.
5. Fill out the patient's clinical history, including any relevant medical information or symptoms that may assist in the interpretation of the test results. It is essential to provide accurate and detailed information to aid in the diagnosis.
6. In the specimen section, provide details about the type of sample being submitted for analysis. This could be a urine sample, bladder washings, or other specific specimens relevant to urovysion cytogenetics. Include any additional instructions or requirements for specimen collection and handling.
7. If necessary, indicate any special considerations or requirements for the test, such as the need for cytology or ancillary testing in conjunction with urovysion cytogenetics.
8. Lastly, review the form for completeness and accuracy before submitting it to the laboratory.

Who needs urovysion requisition form-cytogenetics:

1. Patients experiencing symptoms or conditions related to the urinary tract, such as hematuria (blood in urine), recurrent urinary tract infections, or abnormal cytology results, may need to fill out a urovysion requisition form-cytogenetics. This test helps in the diagnosis and monitoring of various urinary tract disorders.
2. Healthcare providers, including urologists, nephrologists, and gynecologists, may request patients to fill out this form to initiate the urovysion cytogenetics test. By doing so, they can obtain valuable information and insights into the patient's urinary tract health and aid in the appropriate diagnosis and treatment planning.

For pdfFiller’s FAQs

What is urovysion requisition form-cytogenetics?

Urovysion requisition form-cytogenetics is a form used to request cytogenetics analysis for detecting chromosomal abnormalities in urine samples.

Who is required to file urovysion requisition form-cytogenetics?

Patients or healthcare providers are required to file urovysion requisition form-cytogenetics for analysis.

How to fill out urovysion requisition form-cytogenetics?

The form must be filled out completely with patient information, specimen details, clinical history, and the reason for the test.

What is the purpose of urovysion requisition form-cytogenetics?

The purpose of the form is to request cytogenetics analysis for detecting chromosomal abnormalities in urine samples.

What information must be reported on urovysion requisition form-cytogenetics?

Patient information, specimen details, clinical history, and the reason for the test must be reported on the form.

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