University of Utah Health Histocompatibility Testing Requisiton 2013 free printable template

Reset Form registration card imprint or patient demographics BIOCOMPATIBILITY TESTING REQUISITION 30 North 1900 East, SOME, Rm AR121 CIA# 46D0679773 Salt Lake City, UT 84132-1904 Phone (801) 581-3116

How to fill out University of Utah Health Histocompatibility Testing Requisiton

How to fill out University of Utah Health Histocompatibility Testing Requisiton

1. Begin by downloading the University of Utah Health Histocompatibility Testing Requisition form from the official website or obtaining a hard copy from the hospital.
2. Fill in the patient's personal information, including their full name, date of birth, gender, and medical record number.
3. Provide the referring physician's details, including their name, contact information, and any relevant identifying numbers.
4. Indicate the specific tests that are required by checking the appropriate boxes on the form.
5. Include any necessary clinical information that could aid in the testing, such as previous transplant history or relevant medical conditions.
6. Ensure that the form is dated and signed by the referring physician to validate the requisition.
7. Submit the completed form along with the blood or tissue samples to the designated testing laboratory.

Who needs University of Utah Health Histocompatibility Testing Requisiton?

1. Individuals undergoing organ transplantation who require histocompatibility testing.
2. Patients with specific autoimmune disorders that may necessitate compatibility testing.
3. Healthcare providers needing to establish donor-recipient compatibility for blood transfusions or bone marrow donations.

People Also Ask about

What does HLA lab stand for?

HLA stands for human leukocyte antigens. HLA are proteins—or markers—on most cells in your body. Your immune system uses HLA to see which cells belong in your body and which do not.

What is the importance of histocompatibility testing?

Blood Type and Histocompatibility Likewise, histocompatibility testing is performed to help identify recipient/donor combinations that would result in poor allograft survival. Both donor and recipient HLA-A, HLA-B, and HLA-DR antigens of the major histocompatibility complex are determined.

How does HLA matching work?

What is HLA matching? When two people share the same HumanLeukocyte Antigens (abbreviated as HLA), they are said to be a "match", that is, their tissues are immunologically compatible with each other. HLA are proteins that are located on the surface of the white blood cells and other tissues in the body.

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What is University of Utah Health Histocompatibility Testing Requisiton?

The University of Utah Health Histocompatibility Testing Requisition is a formal document used to request histocompatibility testing services, which are essential for organ transplantation and other medical procedures that require tissue matching.

Who is required to file University of Utah Health Histocompatibility Testing Requisiton?

Healthcare providers, such as physicians or medical professionals involved in transplantation, are required to file the University of Utah Health Histocompatibility Testing Requisition when they need to obtain histocompatibility testing for their patients.

How to fill out University of Utah Health Histocompatibility Testing Requisiton?

To fill out the University of Utah Health Histocompatibility Testing Requisition, provide patient information, indication for testing, relevant medical history, and necessary consent. Ensure all fields are completed accurately to prevent delays in processing.

What is the purpose of University of Utah Health Histocompatibility Testing Requisiton?

The purpose of the University of Utah Health Histocompatibility Testing Requisition is to facilitate the accurate matching of organ donors and recipients, ensuring safety and compatibility in transplantation.

What information must be reported on University of Utah Health Histocompatibility Testing Requisiton?

The requisition must include the patient's demographics, clinical diagnosis, type of test required, physician information, and any relevant medical history that could affect the results of the testing.