Get the free Surgical Pathology Consultation Form - University of Mississippi ... - umc
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Billing Office 601-815-9596 Reporting Office 601-984-1596 Department of Pathology 2500 North State Street Jackson, MS 39216 Request for Consultation Referring Physician: Date Sent: Address : Phone:
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How to fill out surgical pathology consultation form
How to fill out surgical pathology consultation form:
01
Obtain the form from the hospital or healthcare facility where the consultation will take place.
02
Read all instructions on the form carefully to ensure understanding of the required information.
03
Begin by providing personal identification details, such as your name, date of birth, and contact information.
04
Indicate the reason for the consultation, including any relevant medical history or symptoms.
05
Specify the healthcare provider who referred you for the consultation and provide their contact information.
06
Include information about any previous surgeries or medical procedures.
07
Provide a detailed description of the current health concern or condition requiring the consultation.
08
Include any relevant diagnostic tests or imaging results, such as X-rays or biopsies.
09
List any medications you are currently taking, including dosage and frequency.
10
If applicable, indicate any allergies or sensitivities to medications or substances.
11
Include any additional relevant information or questions for the pathology consultant.
12
Submit the completed form to the appropriate department or healthcare provider.
Who needs surgical pathology consultation form:
01
Individuals who have undergone a surgical procedure and require a comprehensive pathology consultation.
02
Patients with suspected or confirmed cancerous growths or tumors.
03
Doctors or healthcare providers seeking expert opinion or confirmation of a diagnosis.
04
Individuals with abnormal laboratory results or tissue samples that require further analysis.
05
Patients who require guidance on treatment options based on pathology findings.
06
Individuals with chronic or complex conditions that necessitate a multidisciplinary approach for diagnosis and management.
07
Patients seeking a second opinion or additional information for their medical condition.
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What is surgical pathology consultation form?
The surgical pathology consultation form is a document used to request a consultation from a pathology specialist regarding the examination and diagnosis of tissue samples obtained during surgery.
Who is required to file surgical pathology consultation form?
Surgeons or other healthcare professionals who require an expert opinion or assistance in the interpretation of surgical pathology specimens are required to file the surgical pathology consultation form.
How to fill out surgical pathology consultation form?
To fill out the surgical pathology consultation form, you need to provide relevant patient information, the details of the surgery, specific questions or concerns for the consulting pathologist, and attach relevant laboratory reports or images.
What is the purpose of surgical pathology consultation form?
The purpose of the surgical pathology consultation form is to facilitate communication between the requesting physician and the consulting pathologist, ensuring accurate and thorough assessment of surgical pathology specimens.
What information must be reported on surgical pathology consultation form?
The surgical pathology consultation form typically requires information such as patient demographics, surgical procedure details, relevant clinical history, specimen description, and specific questions or concerns for the consulting pathologist.
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