Get the free POSTNATAL CLINICAL CYTOGENETICS REQUISITION FORM - Pathology - pathology ucla
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Procedure: CATO 012 POSTNATAL CLINICAL CYTOGENETICS REQUISITION FORM Please provide all pertinent information Effective: 10/1/2011 UCLA Cytogenetics Lab accession Number: PATIENT INFORMATION SPECIMEN
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How to fill out postnatal clinical cytogenetics requisition
How to fill out a postnatal clinical cytogenetics requisition?
01
Begin by filling in the patient information section. Include the patient's full name, date of birth, gender, and any other relevant identification details.
02
Next, provide the contact information of the referring healthcare provider. This includes the name, address, telephone number, and any other necessary details.
03
Indicate the reason for the testing in the "Clinical Indication" section. This could include symptoms, suspected genetic disorders, or any other specific concerns.
04
Specify the type of specimen being submitted for cytogenetic analysis. This could be blood, tissue, or any other appropriate sample. Include the collection method and date.
05
If the patient has any known genetic conditions or previous cytogenetic test results, provide that information in the "Clinical History" section. This will help provide context for the analysis.
06
If any specific tests or analyses are required, clearly indicate them in the "Test Requested" section. This could include chromosomal analysis, FISH studies, or any other relevant tests. Provide as much detail as possible.
07
In the "Billing Information" section, indicate the responsible party for payment and any insurance details if applicable.
08
If there are any special instructions or additional information that the laboratory should be aware of, include it in the "Special Instructions" section.
09
Sign and date the requisition form to indicate that all information provided is accurate and complete.
Who needs a postnatal clinical cytogenetics requisition?
01
Healthcare providers who suspect genetic disorders in newborns or individuals post-birth may require a postnatal clinical cytogenetics requisition.
02
Genetic counselors and specialists involved in genetic testing and diagnosis may also need this requisition for further evaluation.
03
Parents or individuals seeking to understand their own or their child's genetic makeup and potential genetic disorders may need to request a postnatal clinical cytogenetics requisition.
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What is postnatal clinical cytogenetics requisition?
Postnatal clinical cytogenetics requisition is a request for genetic testing to assess chromosomal abnormalities in individuals after birth.
Who is required to file postnatal clinical cytogenetics requisition?
Healthcare providers, genetic counselors, or physicians are required to file postnatal clinical cytogenetics requisition for their patients.
How to fill out postnatal clinical cytogenetics requisition?
Postnatal clinical cytogenetics requisition can be filled out by providing patient's demographic information, medical history, reason for testing, and obtaining necessary signatures.
What is the purpose of postnatal clinical cytogenetics requisition?
The purpose of postnatal clinical cytogenetics requisition is to identify genetic abnormalities, diagnose genetic disorders, and guide treatment decisions.
What information must be reported on postnatal clinical cytogenetics requisition?
Information such as patient's name, date of birth, reason for testing, referring physician's information, and insurance details must be reported on postnatal clinical cytogenetics requisition.
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